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Home Care Chronic Disease Prevention Program for Certified Nurse Assistants (CNAs) 
Increasing CNAs' knowledge and skills to help patients manage chronic disease


A grant funded program of The Fullerton Foundation, Inc.


The demand for home-based services continues to grow as the U. S. population continues to age. CNAs provide home-delivered services relied upon by providers and patients and their families. With the escalating use of and demand for CNAs comes the opportunity to build additional skills into Certified Nurse Assistant training to prepare them for a more active role in the care of patients with chronic disease. Teaching CNAs chronic disease management skills can broaden their capacity to help patients with chronic disease.

Expanding home health care training
Certified Nurse Assistants often work in isolation, performing basic but necessary tasks for the patient at home. Often, they are the healthcare provider with the most frequent and consistent face-to-face patient contact. CNAs possess important information about their patients' home environment and functional status. Some CNAs see their patients daily. However, with limited training confined to performing tasks related to activities of daily living (bathing, feeding, etc.,) CNAs have little opportunity to inform the health care provider and less opportunity to support the patient's chronic disease team to improve the health of their patients.

Enhanced training to prepare CNAs to provide simple chronic disease management that includes basic nutrition and physical activity training to reduce the patient's burden of chronic disease, is expected to improve patients' quality of life and reduce the demand for nursing home care. Coupled with rewards for having learned new skills, the CNA is more likely to experience job satisfaction and remain in the health workforce. Some may seek further training to move into more advanced areas of health care. Thus, enhanced training will help the patient, the CNA and the patient's medical team.


CNA training goals
Duke Community Health's CNA training program is operated in conjunction with the University of South Carolina School of Medicine. The CNA training program will strengthen chronic disease care by building CNAs' knowledge and skills enabling the CNA to contribute to patient care beyond performing tasks related to Activities of Daily Living. The curriculum for the CNA Home Care Chronic Disease Prevention Program consists of eleven modules, each facilitated in ninety minute sessions and is designed to:

  • Increase the CNA's knowledge and skills concerning chronic disease and patient coaching skills to decrease the patient's burden of chronic disease. Specific areas of concentration include nutrition, physical activity and smoking cessation.
  • Enable CNAs to serve as integral members of the patient's healthcare team.
  • Increase the knowledge and skills of CNAs to manage and improve their own health behavior, reducing the likelihood of their own chronic illness.

Each training module integrates basic physiology, clinical care guidelines, appropriate preventive care methods and motivational interviewing techniques.

The training program was delivered both through face-to-face sessions and webinars by Duke University's Division of Community Health in North Carolina and the University of South Carolina, School of Medicine in South Carolina. Course material and teaching aids for each of the chronic disease training modules are available on-line under Resources

University of South Carolina School of Medicine

Columbia, SC

For more information

Call (919)681-5724 Monday through Friday from 8 a.m. to 5 p.m. A self-paced Train-the Trainer course developed for Nurse Trainers can be accessed online at Greensboro AHEC (, course name:  Home Care Chronic Disease Prevention Training

Fullerton CNA Program
Division of Community Health
Department of Community & Family Medicine
Duke University Medical Center
DUMC 104425
Durham, North Carolina 27710
Phone: (919) 681-5724
Fax: (919) 681-3371