An intervention designed specifically to meet the needs of a heterogeneous group of chronic disease patients, including those with comorbid conditions, was feasible and beneficial beyond usual care in terms of improved health behaviors and health status. It also resulted in fewer hospitalizations and days of hospitalization.

No abstract

This article develops and tests a reformation of Baumrind's typology of authoritarian, permissive, and authoritative parenting styles in the context of adolescent school performance. Using a large and diverse sample of San Francisco Bay Area high school students (N = 7,836), we found that both authoritarian and permissive parenting styles were negatively associated with grades, and authoritative parenting was positively associated with grades. Parenting styles generally showed the expected relation to grades across gender, age, parental education, ethnic, and family structure categories. Authoritarian parenting tended to have a stronger association with grades than did the other 2 parenting styles, except among Hispanic males. The full typology best predicted grades among white students. Pure authoritative families (high on authoritative but not high on the other 2 indices) had the highest mean grades, while inconsistent families that combine authoritarian parenting with other parenting styles had the lowest grades.

A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.

Objective. To determine the efficacy of an Internet-based Arthritis Self-Management Program (ASMP) as a resource for arthritis patients unable or unwilling to attend small-group ASMPs, which have proven effective in changing healthrelated behaviors and improving health status measures. Methods. Randomized intervention participants were compared with usual care controls at 6 months and 1 year using repeated-measures analyses of variance. Patients with rheumatoid arthritis, osteoarthritis, or fibromyalgia and Internet and e-mail access (n ‫؍‬ 855) were randomized to an intervention (n ‫؍‬ 433) or usual care control (n ‫؍‬ 422) group. Measures included 6 health status variables (pain, fatigue, activity limitation, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 5 utilization variables (physician visits, emergency room visits, chiropractic visits, physical therapist visits, and nights in hospital), and self-efficacy. Results. At 1 year, the intervention group significantly improved in 4 of 6 health status measures and self-efficacy. No significant differences in health behaviors or health care utilization were found. Conclusion. The Internet-based ASMP proved effective in improving health status measures at 1 year and is a viable alternative to the small-group ASMP.