Five factor model personality factors moderated the effects of an intervention to enhance chronic disease management self-efficacy

Center for Healthcare Policy and Research, Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, California 95618, USA.
British Journal of Health Psychology (Impact Factor: 2.7). 10/2008; 14(Pt 3):473-87. DOI: 10.1348/135910708X360700
Source: PubMed


Peer led interventions can enhance patient self-efficacy for managing chronic illnesses, but little is known regarding the moderators or duration of their effects. We hypothesized Homing in on Health (HIOH), a variant of the Chronic Disease Self-Management Program, would be most effective in patients high in neuroticism and low in extraversion, openness, agreeableness, and/or conscientiousness.
Analysis of data from subjects (N=415) enrolled in an ongoing randomized controlled trial.
Regression analyses were conducted to explore whether Five Factor Model (FFM) personality factors moderated the effects of HIOH, delivered in subjects' homes or via telephone, on disease management self-efficacy. Data were collected at 6 time points over the course of 1 year.
Compared with control and telephone HIOH, home HIOH significantly increased self-efficacy, an effect peaking at 6 weeks and fully attenuating by 1 year. Moderation analyses revealed the benefit was confined to patients higher in neuroticism and/or lower in conscientiousness, agreeableness, and extraversion.
A peer led intervention to enhance disease management self-efficacy had only short-term effects, and FFM personality factors moderated those effects. Measuring personality factors in chronically ill individuals may facilitate targeting of self-management interventions to those most likely to respond.

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    • "In partial support of hypotheses regarding moderating effects of personality, analyses revealed short-term benefits of the home intervention on MCS-36 scores were present only in those with low conscientiousness, an interaction that attenuated by 6 months. This finding echoes the results of the prior interim analysis from the RCT, which found beneficial effects of in-home HIOH on illness management self-efficacy were confined to patients lower in conscientiousness (Franks et al., 2009). There are several possible explanations for these findings. "
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    ABSTRACT: Personality factors moderate self-efficacy enhancing effects of some illness self-management interventions, but their influence on self-rated health is unclear. This study examined whether high neuroticism and low conscientiousness, extraversion, and agreeableness (the distressed personality profile) moderated the effects of the homing in on health (HIOH) illness self-management intervention on mental and physical health status. Analysis of data from 384 subjects completing a randomized controlled trial of HIOH. Regression analyses examined effects of NEO-five factor inventory scores on SF-36 mental component summary (MCS-36) and physical component summary (PCS-36) scores (baseline; 2, 4, and 6 weeks; 6 months; 1 year), adjusting for age, gender, and study group. Baseline MCS-36 scores were worse in those with the distressed personality profile relative to others: high neuroticism (13.3 points worse, 95% confidence interval (CI)=11.0, 15.7) and low conscientiousness (6.6 points worse, 95% CI=4.1, 9.2), extraversion (10.1 points worse, 95% CI=7.7, 12.5) and agreeableness (4.2 points worse, 95% CI=1.6, 6.8). Intervention subjects had better MCS-36 scores at 4 and 6 weeks, and benefits were confined to participants with low conscientiousness (4 weeks - 3.7 points better, 95% CI=0.2, 71; 6 weeks - 5.0 points better, 95% CI=1.57, 8.4). There were no intervention or personality effects on PCS-36 scores. Chronically ill self-management intervention recipients with the distressed personality profile had worse self-rated mental health, and conscientiousness moderated the short-term effects of the intervention on self-rated mental health. Measuring personality may help identify individuals more likely to benefit from self-management interventions.
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