Living Well Together: A Chronic Disease Self-Management Program for Older African Americans with Chronic Illness

 描述（由申请人提供）：慢性心血管（CV）疾病，如糖尿病、高血压和中年高胆固醇血症，会增加痴呆的风险。非裔美国人社区承担着不成比例的慢性病负担，并继续面临着医疗保健领域的差异。改善CV风险因素的控制可以改善身体和认知健康，并可能提供降低痴呆风险的方法，但有证据表明，难以遵守治疗建议是常见的。健康自我管理计划，如慢性病自我管理计划（CDSMP）旨在通过提高参与者的健康自我效能来解决这个问题，尽管很少有研究专门关注非裔美国人参与者的经历。拟议的研究的总体目标是确定影响参与和参与的关键因素，在一个样本中，老年非裔美国人患有慢性疾病，他们要么完成，退出，或拒绝参加修改后的版本的CDSMP称为共同生活（LWT）。据推测，LWT计划的独特修改对该样本的参与和参与产生了积极影响。本研究提出通过比较两个项目的出勤率和流失率来验证这一假设，并确定和描述与项目参与和流失相关的关键促进和复杂因素，以及探索对健康行为的持续影响。混合方法的方法将用于深入了解LWT参与者和项目负责人的经验和观点，这些信息将用于为未来针对少数民族成年人健康老龄化的干预措施的设计，开发和测试提供信息。本研究的长期目标是通过改善生命早期CV风险因素的管理来解决衰老和神经退行性疾病的健康风险，并与国家卫生研究院和疾病控制中心关于促进健康老龄化和减少慢性病健康差异的优先事项保持一致。

 DESCRIPTION (provided by applicant): Chronic cardiovascular (CV) conditions such as diabetes, hypertension, and hypercholesterolemia in midlife increase the risk for dementia. The African American community bears a disproportionate amount of chronic disease burden, and continues to face disparities across the healthcare spectrum. Improved control of CV risk factors improves both physical and cognitive health, and may provide a means to reducing dementia risk, but evidence shows that difficulty with adherence to treatment recommendations is common. Health self- management programs such as the Chronic Disease Self-Management Program (CDSMP) are designed to addressthis issue by increasing participant health self-efficacy, though few studies have specifically focused on the experiences of African American participants. The overall objective of the proposed study is to identify key elements influencing participation and engagement in a sample of older African American adults with chronic illness who either completed, withdrew, or declined to participate in a modified version of the CDSMP called Living Well Together (LWT). It is hypothesized that the unique modifications of the LWT program positively impacted participation and engagement in this sample. The study proposes to test this hypothesis through a comparison of attendance and attrition rates between the two programs, and identification and description of key facilitating and complicating factors associated with program engagement and attrition, as well as an exploration of the sustained effects on health behaviors. A mixed methods approach will be used to gain insight into the experiences and perspectives of LWT participants and program leaders, and this information will be used to inform the design, development and testing of future interventions targeting healthy aging for minority adults. The long term goal of this study is to address health disparitie in aging and neurodegenerative diseases through improved management of CV risk factors earlier in life, and is in alignment with National Institute of Health and Centers for Disease Control priorities on promoting healthy aging and reducing health disparities in chronic illness.