Gitlin et al. (2008)

Test effectiveness of translating the CDSMP to African American Seniors

Self-Efficacy Theory and Translational Theory

Senior Centers, Churches, community centers

U.S.

・ Pre-post design

・ Lay leaders retired community member (1 nurse)

・ 6-week course, met weekly

・ N = 519

・ African American

・ Mean Age:73 years

・ 86% Female

・ Heterogeneous Disease population

・ Education level 41% High School

・ 44% Secondary Education

・ Average had 3 chronic conditions

・ Heterogeneous Disease Sample

・ Measured outcomes from CDSMP at 4 months:

・ Physical Activity

・ Cognitive Symptom management

・ Health Status

・ Communication with Providers

・ Health distress

・ Health care utilization

・ Illness intrusiveness

・ Self-Efficacy

・ Validity and Reliability addressed

・ Small statistical significance in cognitive symptoms management (p = 0.01), self-efficacy (p = 0.001), health distress (0.001), exercise (p = 0.001)

・ No change in healthcare utilization

Interpretation:

Translates to the African American Population. Results adapt for lower levels of education and rename to give historical and biblical significance

Future Research needed to see if booster sessions would increase effect.

Limitations: not reported, Volunteers, Self-report

Generalizability: to African American Population, volunteers could limit generalizability

2b

Harvey, P.W., et al. (2008)

Test a structured care plan version of the CDSMP

None Stated

Primary Care

Harvey

・ Mixed method, longitudinal study

・ Initial care planning session and then group participation in CDSMP

・ Measured at baseline and 6 months

・ N = 175

・ Mean Age 68

・ 61% Female

・ Aboriginal and non-Aboriginal sample

・ Heterogeneous disease mix

Measured Partners in Health survey and Stanford 2000 Health Survey

Positive change in outcomes, healthcare utilization, and pain management

Interpretation:

Small effect sizes suggest that program has positive effect on sample.

Limitations: Small sample size, Lack of control Group

Generalizability: Due to convenience sample and small sample size, cannot be generalized.

2b

Klug et al. (2008)

Describe the feasibility and outcomes in a diabetes self-management program

None Stated

Urban and suburban community centers, weekly meetings

Lay leaders of similar characteristics, known and respected in community U.S.

・ Mixed method, pre and post data collection

・ 6-month pilot study

・ N = 144

・ Mean Age: 69

・ 24% non-Caucasian

・ 81% female

・ Education: 60% High School or Less

・ Diagnosed with Type II Diabetes

・ -Demographics

・ -Diet and physical activity changed

・ -Self-efficacy

・ -Community Resources using the Chronic Illness Resources Survey

・ (Validity and Reliability not addressed by author)

・ Related length of disease and increased self-efficacy (P = 0.017) predictors of change

・ Self-rated health (P.001) did not meet previously documented levels in CDSMP

・ CIRS results not discussed

Interpretation:

Identified gap of community based diabetes resources for older adult. Barriers to attending: transportation, inconvenient location and times

Limitations:

Lacked control group, self-report measures in assessing outcomes, difficulty in obtaining resources for class, 4 month survey participation declined sharply

Generalizability:

Need further research to identify suitable program length, increased goal attainment work in program, small sample size unable to determine generalizability, volunteers could limit generalizability

2b

LaForest et al. (2008)

Evaluation of adapted CDSMP on homebound frail older adults with arthritis

Social Cognitive Theory

6 weekly 1 hour visits to homebound

U.S.

Lay leaders all healthcare providers

・ Randomized, experimental design

・ Measurements at screening, immediately pre-intervention, immediately post intervention, and at 8 weeks

・ Randomly assigned to control group and intervention group.

・ N = 125

・ Control group mean age: 77 (91% female)

・ Intervention group mean age: 78 (90% female)

・ Ethnicity not reported

・ 19% perceived low income,

・ Education: 9 years of education

・ Diagnosed with arthritis

・ Demographics

・ Health Activities:

・ Physical (Cronbach’s alpha 0.77) or Social (Cronbach’s alpha 0.74)

・ Pain

・ Stiffness

・ Fatigue

・ Functional limitations

・ Helplessness

・ Coping Effectiveness

・ Self-efficacy: Arthritis-Self- Efficacy Scale

・ (Validity and reliability previously established)

・ Outcome expectations of program were measured with using developed self-report questions (Cronbach’s alpha .58)

・ Statistically significant decrease in functional limitation (P = 0.04)

・ Helplessness decrease (P = 0.05)

・ -Other variables not statistically significant

Interpretation:

Those that had the greatest change in physical health behaviors and outcome expectations had greater benefits from the program although the effect on pain, stiffness, and fatigue were minimal.

Self-efficacy did not have the biggest effect as a moderator, but outcome expectations were more predictive.

Limitations:

Self-reported data, low instrument reliability, small sample size

Generalizability: not generalizable to frail adults as a whole, volunteers could limit generalizability

1b