Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting
Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting
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DOI：
10.1093/geront/48.5.698
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发表时间：
2008-10-01
期刊：
影响因子：
5.7
通讯作者：
Dennis, Marie P.
中科院分区：
文献类型：
--
作者：
Gitlin, Laura N.;Chernett, Nancy L.;Dennis, Marie P.
目的：我们描述了K. R. Lorig及其同事的慢性疾病自我管理计划（CDSMP）在老年中心交付的翻译，并评估非裔美国人参与者的产后福利。设计和方法：对CDSMP的修改包括名称更改；额外的介绍性会议；课程扩展包括与文化相关的食物，减压技术，以及与不同种族/民族的医生交流。我们从老年中心成员、地区教会和口口相传中招募参与者。我们进行了基线和4个月后的访谈。结果：共有569名非裔美国老年人参加了介绍性会议，其中519人（91%）参加了6次会议的计划。在519人中，444人（86%）完成了>= 4次访谈，414人（79%）完成了前后访谈。我们发现运动（p = 0.001）、认知管理策略的使用（p = 0.001）、能量/疲劳（p = 0.001）、自我效能（p = 0.001）、健康困扰（p = 0.001）和疾病在不同生活领域（概率从0.001 - 0.021）的改善很小，但在统计学上有显著意义。我们发现健康利用率没有变化。结果没有因性别、参加会议的次数、慢性病的数量和类型、推动者、领导者或招聘地点而有所差异。意义：CDSMP可以由训练有素的老年中心人员翻译给非裔美国老年人。与最初的试验结果相比，参与者的获益更好。翻译后的方案是可复制的，可能有助于解决健康差距问题。
Purpose: 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. Design and Methods: 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. Results: 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. Implications: 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.