Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting

Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, PA 19107, USA.
The Gerontologist (Impact Factor: 3.21). 10/2008; 48(5):698-705. DOI: 10.1093/geront/48.5.698
Source: PubMed

ABSTRACT We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants.
Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews.
A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed >/=4 sessions and 414 (79%) completed pre-post interviews. We found small but statistically significant improvements for exercise (p =.001), use of cognitive management strategies (p =.001), energy/fatigue (p =.001), self-efficacy (p =.001), health distress (p =.001), and illness intrusiveness in different life domains (probabilities from.001-.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site.
The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities.

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    • "Patients’ attendance rates were recorded each week. Adherence to the programme was considered to be attendance at four or more education sessions [20]. "
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    BMC Pulmonary Medicine 08/2013; 13(1):50. DOI:10.1186/1471-2466-13-50 · 2.40 Impact Factor
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    • "For example, Griffiths examined the Chronic Disease Self-Management Program and found an improvement in self-efficacy (effect size 0.67) [47]. Gitlin found a 0.6 mean change in self-efficacy following a Chronic Disease Self-Management Program which was statistically significant and considered to be an improvement [48]. While we don’t know if the increase in participants’ confidence to manage their condition will result in longer term change in outcomes, self-efficacy has been shown to relate to adaptive pain behaviours in arthritis [49]. "
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    BMC Research Notes 12/2012; 5(1):669. DOI:10.1186/1756-0500-5-669
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    • "These moderate, short-term results among CHF patients as well as the inconsistent findings in previous CDSMP studies raise the issue whether the extent to which the programme is effective partly depends on patient characteristics. Although considerable research has been conducted on the effectiveness of the CDSMP, only a few studies explored the differential effects of patientrelated factors on programme outcomes [10] [20] [26] [31] [33] [39]. In the present study, we aim to gain insight into which CHF patients benefited most from the programme in terms of cardiac-specific quality of life by conducting additional subgroup analyses. "
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