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

 描述(由申请人提供)：慢性心血管疾病，如糖尿病、高血压和中年高胆固醇血症，会增加患痴呆症的风险。非洲裔美国人社区背负着不成比例的慢性病负担，并继续面临医疗保健领域的差异。改善对心血管危险因素的控制可以改善身体和认知健康，并可能提供一种降低痴呆症风险的方法，但有证据表明，遵守治疗建议的困难是常见的。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一问题，尽管很少有研究专门关注非裔美国人参与者的经历。这项拟议研究的总体目标是确定影响参与和参与的关键因素，样本是患有慢性病的老年非裔美国人，他们要么完成、退出或拒绝参加CDSMP的修订版，称为共同生活(LWT)。假设LWT项目的独特修改对本样本的参与度和参与度产生了积极影响。这项研究建议通过比较两个项目的出勤率和流失率，识别和描述与项目参与度和流失率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来检验这一假设。将使用混合方法来洞察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族裔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。这项研究的长期目标是通过改善对生命早期心血管风险因素的管理来解决衰老和神经退行性疾病方面的健康差异，并与国家卫生研究所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.