Community Health Navigation

In the Community

Community Health Navigation Program: Care Transitions, Chronic Disease Management, and Peer Support

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Care Transitions: Hospital to Home
As part of our commitment to support aging adults in the community, JASA has launched a Care Transitions program pilot to improve hospital to home care transitions. Older adults are provided access to community support and evidence-based strategies in which we provide a 30-day intervention to prevent avoidable readmissions for high risk patients living in New York City in partnership with hospital and clinical partners to prevent hospitalizations.

Chronic Disease Management
JASA’s evidence-based workshops developed by Stanford University’s Patient Education Research Center supports participants as they develop skills needed in the day-to-day management of chronic health conditions. Participants meet in community settings for 2.5 hours for six highly interactive weekly sessions that focus on sharing experiences and skills-building. The workshops are facilitated by trained Peer Leaders or Master Trainers in pairs, one or both of whom is living with a chronic health condition. Stanford Self-Management programs are designed to complement and enhance traditional clinical treatment and disease specific education programs. The programs are provided in English and Spanish and are complemented with physical activity and nutrition programs.

Peer Support
JASA’s Community Health Navigators aged 65+ have learned to manage their diabetes, hypertension and other chronic conditions and are committed to helping others in their communities do the same; to overcome any barriers they may face in the healthcare system and facilitate access to all types of medical care, emotional and social support. They provide evidence-based group programs as well as one-on-one coaching to empower older adults to proactively participate in their own health and healthcare.

Community Health Programs are currently provided in English and Spanish. 

These programs are piloting in North Brooklyn and have capacity to scale. We welcome inquiries from partners. Please contact us at: CHN@JASA.ORG

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  • I have lived in JASA housing for 12 years. The staff helped me apply for food stamps and get a home care attendant.
    - Arthur
  • Knowing that JASACare Home Care was able to provide a home care attendant for my sister, after she came home from the hospital, is the definition of peace of mind for my family.
    - Bruce