Intermediate Outcomes of a Chronic Disease Self-Management Program for Spanish-Speaking Older Adults in South Florida, 2008–2010

Melchior, Michael A.; Seff, Laura R.; Bastida, Elena; Albatineh, Ahmed N.; Page, Timothy F.; Palmer, R. C.

doi:10.5888/pcd10.130016

Cited by 28 publications

(16 citation statements)

References 21 publications

(30 reference statements)

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“…The differences between Hispanic and non-Hispanic and by level of comorbidity were the largest. Previous studies have shown greater difficulty in disease management among Hispanics, perhaps due to language and cultural barriers, lack of access to preventive services, lack of insurance, and greater medical comorbidity[42]. The mean SEMCD6 rating for the Hispanic sample in this study is similar to those reported in two randomized controlled trials of disease management among Hispanics[42].…”

Section: Discussionsupporting

confidence: 72%

Validation of the PROMIS® measures of self-efficacy for managing chronic conditions

et al. 2017

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Purpose The Patient-Reported Outcomes Measurement Information System® (PROMIS®) was designed to develop, validate, and standardize item banks to measure key domains of physical, mental and social health in chronic conditions. This paper reports the calibration and validation testing of the PROMIS Self-Efficacy for Managing Chronic Conditions measures. Methods PROMIS Self-Efficacy for Managing Chronic Conditions item banks comprise five domains, Self-Efficacy for Managing: Daily Activities, Symptoms, Medications and Treatments, Emotions, and Social Interactions. Banks were calibrated in 1087 subjects from two data sources: 837 patients with chronic neurologic conditions (epilepsy, multiple sclerosis, neuropathy, Parkinson disease, and stroke) and 250 subjects from an online internet sample of adults with general chronic conditions. Scores were compared with one legacy scale: Self-Efficacy for Managing Chronic Disease 6-Item scale (SEMCD6) and five PROMIS short forms: Global Health (Physical and Mental), Physical Function, Fatigue, Depression, and Anxiety. Results The sample was 57% female, mean age=53.8 (SD=14.7), 76% white, 21% African American, 6% Hispanic and 76% with greater than high school education. Full item banks were created for each domain. All measures had good internal consistency and correlated well with SEMCD6 (r=0.56–0.75). Significant correlations were seen between the Self-Efficacy measures and other PROMIS short forms (r>0.38). Conclusions The newly developed PROMIS Self-Efficacy for Managing Chronic Conditions measures include five domains of self-efficacy that were calibrated across diverse chronic conditions and show good internal consistency and cross-sectional validity.

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Section: Discussionsupporting

confidence: 72%

Validation of the PROMIS® measures of self-efficacy for managing chronic conditions

et al. 2017

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“…Structured self-management programmes have been shown to improve a wide range of outcomes in older adults. Improvements have been observed in physical activity, 27 – 29 self-care, 27 chronic pain 30 and self-efficacy. 27 – 30 …”

Section: Who’s Approachmentioning

confidence: 99%

Organizing integrated health-care services to meet older people’s needs

Carvalho

Epping‐Jordan

Pot

et al. 2017

Bull. World Health Organ.

195

149

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In most countries, a fundamental shift in the focus of clinical care for older people is needed. Instead of trying to manage numerous diseases and symptoms in a disjointed fashion, the emphasis should be on interventions that optimize older people’s physical and mental capacities over their life course and that enable them to do the things they value. This, in turn, requires a change in the way services are organized: there should be more integration within the health system and between health and social services. Existing organizational structures do not have to merge; rather, a wide array of service providers must work together in a more coordinated fashion. The evidence suggests that integrated health and social care for older people contributes to better health outcomes at a cost equivalent to usual care, thereby giving a better return on investment than more familiar ways of working. Moreover, older people can participate in, and contribute to, society for longer. Integration at the level of clinical care is especially important: older people should undergo comprehensive assessments with the goal of optimizing functional ability and care plans should be shared among all providers. At the health system level, integrated care requires: (i) supportive policy, plans and regulatory frameworks; (ii) workforce development; (iii) investment in information and communication technologies; and (iv) the use of pooled budgets, bundled payments and contractual incentives. However, action can be taken at all levels of health care from front-line providers through to senior leaders – everyone has a role to play.

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“…The conceptual model in this study was based on the chronic care model launched by Wagner and colleagues in 1999 19. The chronic care model has been considered to be an effective framework for improving the quality of diabetes care 20. This model includes six core elements for the provision of optimal care of patients with chronic diseases 21.…”

Section: Conceptual Framework For the Studymentioning

confidence: 99%

<p>Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial</p>

Guo¹,

Liu²,

Zeng³

et al. 2019

PPA

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Aim The aim of this study was to examine the feasibility and efficacy of nurse-led team management (NLTM) intervention at improving the self-management of patients with type 2 diabetes (T2D) at community settings in Changsha, Hunan, China. Background China has become the country with the largest number of patients with diabetes, and that number is growing, causing increasing pressure on the health care system. At present, the main diabetes management model in China is teamwork guided by general practitioners. However, the number of general practitioners is insufficient, and their work is overloaded, which leads to poor outcomes of diabetes management. Therefore, it is important to explore alternative methods of diabetes management, such as NLTM. Patients and methods In a randomized controlled trial, 171 T2D patients were randomized into the control or intervention arm. Participants in the control group received routine management from the community health service center, whereas the intervention group received 12 months NLTM intervention in addition to the standard care. The diabetes self-management scale, fasting blood sugar, and glycosylated hemoglobin A1c (HbA1c) were assessed at baseline and at 6 and 12 months after the start of the intervention. Results Baseline data were comparable between arms. Repeated-measurement analysis showed that self-management of the intervention group improved compared with the control group after the intervention ( P <0.05). There were no significant differences in HbA1c at 6 months, whereas after 12 months of intervention, there was a significant difference in HbA1c between the two groups (F=10.114, P <0.05). The intervention had no significant effect on fasting blood sugar. Conclusion The NLTM intervention has resulted in an impact of practical significance on T2D self-management, and was beneficial for controlling the level of HbA1c. The study has demonstrated the feasibility and efficacy of using NLTM in the management of T2D in a Chinese community.

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Intermediate Outcomes of a Chronic Disease Self-Management Program for Spanish-Speaking Older Adults in South Florida, 2008–2010

Cited by 28 publications

References 21 publications

Validation of the PROMIS® measures of self-efficacy for managing chronic conditions

Validation of the PROMIS® measures of self-efficacy for managing chronic conditions

Organizing integrated health-care services to meet older people’s needs

<p>Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial</p>

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