Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Jean Goeppinger, PhD, Schools of Nursing and Public Health, The University of North Carolina at Chapel Hill, College Drive, Chapel Hill, NC 27599, 919-966-4338, jgoeppin@email.unc.edu, Don Ensley, PhD, Department of Community Health, Eastern Carolina University, Belk 302 F, Greenville, NC 27858, and Sydney Barnwell, MD, Craven County Health Department, 2818 Neuse Boulevard, New Bern, NC 28561.

Health disparities in chronic disease are pronounced. Co-morbidity is high and increasing. Consequently, we compared the effectiveness of two evidence-based disease self-management programs: the Arthritis Self-Help Course/ASHC and the generic Chronic Disease Self-Management Program/CDSMP. Two hundred eight rural African Americans with arthritis were randomized to the ASHC, and 157 to the CDSMP. Changes in outcomes were examined at 4 and 12 months. Differences within and between the ASHC and CDSMP were assessed with paired t-tests and analyses of covariance. The sample was primarily female (81%), married or widowed (43%/32%), elderly (mean 64 years), educated at a high school level, and lived in rural NC communities. Sixty nine per cent (69%) had > 3 chronic conditions; 57% had > 4. At 4 months, both ASHC and CDSMP participants showed statistically significant improvements in arthritis self-efficacy; aerobic, stretching and strengthening exercise; and self-reported health. CDSMP participants also showed statistically significant improvements in cognitive symptom management, health distress, pain, and disability. When compared to ASHC participants, CDSMP participants made significantly stronger improvements in pain and disability. None of these improvements were apparent at 12 months. The decrease in physician visits at 12 months, however, was significantly greater among CDSMP participants. These findings suggest that: 1) disease self-management programs can improve the health of African Americans; 2) improvements are primarily short-term; and 3) the CDSMP may be more effective disease self-management for populations experiencing considerable co-morbidity.

Learning Objectives: At the end of this session, participants will be able to

• Compare outcomes of arthritis-specific and generic chronic disease self-management programs among rural African American elders.
• Discuss the practice implications of these findings.

Keywords: Chronic Illness, Evidence Based Practice

Presenting author's disclosure statement:

Not Answered