Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities.

Full Abstract

OBJECTIVE:
To compare short-term and long-term effectiveness of the Arthritis Self-Help Course (ASHC) and the Chronic Disease Self-Management Program (CDSMP) for persons with arthritis concerning health care use, health-related quality of life, health behaviors, and arthritis self-efficacy.

METHODS:
Forty-eight workshops were randomized to the ASHC (n = 26) or CDSMP (n = 22). A total of 416 individuals, including 365 African Americans, participated. The mean age for each group was 64 years, mean years of education was 11.7, mean number of chronic conditions was 4, and 75-80% of participants in each group were female. Multivariate statistical tests were used to assess effectiveness within and between programs for all workshop participants and African Americans.

RESULTS:
At 4 months all ASHC participants including African Americans, had significant improvements (P <or= 0.05) in self-efficacy, stretching and strengthening exercises, aerobic exercises, and general health. All CDSMP participants had statistically significant improvements in self-efficacy, disability, pain, and general health. African American CDSMP participants showed statistically significant improvements in general health. Trends toward improvement (P = 0.051-0.100) were shown in 5 variables among African American CDSMP participants and in 4 variables among all CDSMP participants. Statistically significant differences between the 2 programs at 4 months were seen in pain and disability in both groups. The CDSMP produced stronger results. Significant results at 1 year within and between programs were minimal for both groups.

CONCLUSION:
When populations with arthritis and multiple comorbid conditions are targeted, the CDSMP may be most cost effective.

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Author information

Author/s: Goeppinger, Jean (J); Armstrong, Brian (B); Schwartz, Todd (T); Ensley, Donald (D); Brady, Teresa J (TJ);

Affiliation: University of North Carolina at Chapel Hill, Schools of Nursing and Public Health, Chapel Hill, NC 27599-7460, USA. jgoeppin(-atsign-)email.unc.edu

Grants: CDC 52233-22/22 (Agency:United States PHS)

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Intramural; Research Support, U.S. Gov't, P.H.S.

Journal: Arthritis and rheumatism (Arthritis Rheum), published in United States. (Language: eng)

Reference: 2007-Aug; vol 57 (issue 6) : pp 1081-8

Dates: Created 2007/08/28; Completed 2007/09/13; Revised 2007/11/15;

PMID: 17665471, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

African Americans
Aged
Arthritis - complications; nursing; physiopathology
Comorbidity
Female
Health Behavior
Health Services - utilization
Humans
Male

Male
Middle Aged
Outcome Assessment (Health Care)
Patient Education as Topic - methods
Programmed Instruction as Topic
Quality of Life
Self Care
Self Efficacy
Time Factors

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