Supplement: Healthy Together: A self-management and support intervention for low-income African-American men with multiple chronic conditions

项目摘要/摘要：尽管在慢性病自我管理方面有很多研究，

PROJECT SUMMARY/ABSTRACT: Despite much research in chronic disease self-management, significant gaps in knowledge still exist, especially regarding vulnerable and underserved populations. More specifically, low-income African American men are disproportionately affected by chronic conditions, especially coping with multiple morbidities. Low-income African American men also experience additional burdens to health related to cultural beliefs and practices about health, knowledge and perceptions regarding chronic conditions, and lack of support systems, creating even greater health inequalities. The critical intersections of socioeconomic status, race/ethnicity, gender, geographic location, and multiple diagnoses strongly influence effective self-management skills and access to support systems. The specific aims for this bioethical issues supplement to Healthy Together: A Self-Management and Support Intervention for Low- Income African American Men with Multiple Chronic Conditions” include: AIM 1: Conduct focus groups with low-income African American men and their health care providers to explore issues and themes related to bioethical issues as lived by the participants; AIM 2: Develop a specific bioethical issues module for low-income African American men with multiple chronic conditions to be added to the NIH funded self-management and support program, Healthy Together, as well as a separate training module for clinical and research staff; and AIM 3: Implement and evaluate a non-experimental pilot study for these bioethical issues modules with at least 50 low- income African American men with multiple chronic conditions and at least 20 clinical and ethics staff, including pre/posttests assessment at baseline, intervention completion, and 3-month follow-up. The purpose of this study is to carefully examine the development and effectiveness of integrating specific bioethical issues into a peer-led self-management and support curricula specifically designed for low-income African American men with multiple morbidities, both chronic physical and mental conditions, as well as those who care for them. This innovative study engages the research participants through community based participatory research to address the complexities of clinical and research-oriented bioethical issues related to effectively managing their chronic diseases. This will advance the science needed to achieve the clinically important outcomes such as minimizing disability, optimizing function, and living well among all patients.