implementing the chronic disease self-management program ...€¦ · • self-management programs...

• Self-management programs are widely used to manage chronic symptoms. • The Chronic Disease Self-Management Program (CDSMP) has been implemented with success for a variety of chronic conditions across demographic groups. • CDSMPs have been shown to improve empowerment and confidence, as well as teach self-management skills. • Outcomes for CDSMPs in rural and remote regions are not well understood. • To understand the benefits and limitations of delivering a CDSMP to adults and older adults living in rural and remote regions of the Rocky Mountain West. Recruitment • Participants were enrolled in and completed a chronic disease self-management program. Instruments • Demographics were assessed using a participant profile form designed for this study. Analysis • SPSS version 24 was utilized for analysis. • Paired-samples t-tests were used to compare pre- and post-evaluation responses. • Alpha set to p < .05. Participant Characteristics • Wyoming residents (n = 50) Statistical Findings • Results of paired-samples t-tests revealed participation in CDSMP: • Significantly reduced depressive symptoms, t(49) = 2.397, p = .020. • Significantly improved self-efficacy, t(48) = -2.887, p = .006. • Significant outcomes were not found for changes in activities of daily living, medical care and associated behaviors, quality of life, or other psychological measures. 1. INTRODUCTION 2. OBJECTIVES 3. METHODS 4 4. RESULTS 4 5. CONCLUSIONS • The CDSMP appears to be useful in improving confidence in ability to self-manage chronic symptoms, as well as improving symptoms of depression, in rural and remote regions. • Significant findings were not found for other assessed variables such as utilization of health care, social support, or physical symptoms like fatigue, pain, and sleep quality. • Future directions include inclusion of a larger sample with a longer follow-up period, as well as qualitative review of barriers and facilitators of changes within CDSMPs. Implementing the Chronic Disease Self-Management Program in Rural and Remote Areas Morgan E. Longstreth, Dominick Duhamel, Catherine P. Carrico, Robin A. Barry, Andrea E. Slosser, and Christine L. McKibbin This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant No. U1QHP28743, Geriatric Workforce Enhancement Program, $2,549,927. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. 0.932 0.687 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 Mean Mood Symptom Score Change in Depressive Symptoms from Baseline to Post-Intervention Baseline Post 6.608 7.605 0 1 2 3 4 5 6 7 8 Mean Self-Efficacy Score Change in Self-Efficacy from Baseline to Post-Intervention Baseline Post

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• Self-managementprogramsarewidelyusedtomanagechronicsymptoms.

• TheChronicDiseaseSelf-ManagementProgram(CDSMP)hasbeenimplementedwithsuccessforavarietyofchronicconditionsacrossdemographicgroups.

• CDSMPshavebeenshowntoimproveempowermentandconfidence,aswellasteachself-managementskills.

• OutcomesforCDSMPsinruralandremoteregionsarenotwellunderstood.

• TounderstandthebenefitsandlimitationsofdeliveringaCDSMPtoadultsandolderadultslivinginruralandremoteregionsoftheRockyMountainWest.

Recruitment• Participantswereenrolledinandcompletedachronicdiseaseself-managementprogram.

Instruments• Demographicswereassessedusingaparticipantprofileformdesignedforthisstudy.

Analysis• SPSSversion24wasutilizedforanalysis.• Paired-samplest-testswereusedtocomparepre-andpost-evaluationresponses.

• Alphasettop <.05.

ParticipantCharacteristics• Wyomingresidents(n =50)StatisticalFindings• Resultsofpaired-samplest-testsrevealedparticipationinCDSMP:

• Significantlyreduceddepressivesymptoms,t(49)=2.397,p =.020.

• Significantlyimprovedself-efficacy,t(48)=-2.887,p =.006.

• Significantoutcomeswerenotfoundforchangesinactivitiesofdailyliving,medicalcareandassociatedbehaviors,qualityoflife,orotherpsychologicalmeasures.

1.INTRODUCTION

2.OBJECTIVES

3.METHODS

4.RESULTS

5.CONCLUSIONS• TheCDSMPappearstobeusefulinimprovingconfidenceinabilitytoself-managechronicsymptoms,aswellasimprovingsymptomsofdepression,inruralandremoteregions.

• Significantfindingswerenotfoundforotherassessedvariablessuchasutilizationofhealthcare,socialsupport,orphysicalsymptomslikefatigue,pain,andsleepquality.

• Futuredirectionsincludeinclusionofalargersamplewithalongerfollow-upperiod,aswellasqualitativereviewofbarriersandfacilitatorsofchangeswithinCDSMPs.

ImplementingtheChronicDiseaseSelf-ManagementPrograminRuralandRemoteAreas

MorganE.Longstreth,DominickDuhamel,CatherineP.Carrico,RobinA.Barry,AndreaE.Slosser,andChristineL.McKibbin

ThisprojectissupportedbytheHealthResourcesandServicesAdministration (HRSA)oftheU.S.DepartmentofHealthandHumanServices(HHS)underGrantNo.U1QHP28743,GeriatricWorkforceEnhancementProgram,$2,549,927. Thisinformationorcontentand conclusionsarethoseoftheauthorandshouldnotbeconstruedastheofficial positionorpolicyof,norshouldanyendorsementsbeinferredbyHRSA,HHSortheU.S.Government.

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