The effect of a community-based group intervention on chronic disease self-management in a vulnerable population

Frontiers in Public Health

Public Health

Alberto Pilotto¹  Hein Raat²  Sophie A. Korenhof²  Ellen V. Rouwet²  Irene N. Fierloos²  Xuxi Zhang³  Liset E. M. Elstgeest⁴  Siok Swan Tan⁵  Yves-Marie Pers⁶  An L. D. Boone⁷  Isabel Diez Valcarce⁸  Marta M. Pisano-Gonzalez⁸  Mónica López-Ventoso⁸ 

[1] Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy;Department of Interdisciplinary Medicine, University of Bari, Bari, Italy;Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands;Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands;Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China;Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands;Reinier Academy, Reinier de Graaf Hospital, Delft, Netherlands;Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands;Research Group City Dynamics, InHolland University of Applied Sciences, Rotterdam, Netherlands;IRMB, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France;Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Department of Rheumatology, Lapeyronie University Hospital, Montpellier, France;Public Health General Directorate, Ministry of Health of the Principality of Asturias, Oviedo, Spain;Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain;

关键词: chronic disease management;    self-management;    risk factors;    vulnerable populations;    socioeconomic factors;    caregivers;   

DOI  :  10.3389/fpubh.2023.1221675

 received in 2023-05-12, accepted in 2023-07-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionChronic non-communicable diseases (NCDs) are predominantly related to modifiable health behaviors and account for 74% of global deaths at present. Behavior modification through self-management is a strategy to prevent NCDs. Chronic Disease Self-Management Programs (CDSMPs) have demonstrated improvements in health behaviors, health status, and use of healthcare.ObjectiveWe evaluated the effects of a 6-week CDSMP on self-efficacy, health behaviors, mental health, health-related quality of life (HR-QoL), and health responsibilities among vulnerable populations with chronic disease in Europe.MethodsA prospective cohort study with a 6-month pre-post single-group design was conducted in five European countries. The intervention targeted adults with chronic conditions and low socioeconomic status, as well as their caregivers. The intervention was a 6-week community-based CDSMP in a group setting. Outcomes were measured per self-report questionnaire at baseline and 6-month follow-up: self-efficacy, health behaviors, mental health, HR-QoL, and health responsibilities.ResultsOf 1,844 participants, 1,248 (67.7%) completed follow-up and attended ≥4 sessions. For the chronic condition group, the following outcome measures at follow-up significantly improved compared with baseline (all P < 0.002): self-efficacy (SEMCD-6 6.7 vs. 6.4), mental health (PHQ-8 6.3 vs. 7.0), HR-QoL (SF-12 PCS 42.3 vs. 40.2, SF-12 MCS 42.8 vs. 41.4), health utility (EQ-5D-5L 0.88 vs. 0.86), self-rated health (EQ-5D-5L 67.2 vs. 63.9), communication with healthcare providers (2.28 vs. 2.11), understanding information (3.10 vs. 3.02), number of doctor visits (3.61 vs. 4.97), accident and emergency department visits (0.25 vs. 0.48), total nights in a hospital (0.65 vs. 1.13), and perceived medical errors (19.6 vs. 28.7%). No significant changes were detected in dietary habits, physical activity, substance use, and sleep and fatigue. For caregivers without a chronic condition, only doctor visits significantly decreased (1.54 vs. 2.25, P < 0.001).DiscussionThis CDSMP was associated with improvement in self-efficacy, depression, HR-QoL, and health responsibilities over 6 months in a diverse European population with a chronic condition. However, additional interventions targeting lifestyle risk factors are needed to improve health outcomes.

【 授权许可】

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Copyright © 2023 Korenhof, Rouwet, Elstgeest, Fierloos, Tan, Pisano-Gonzalez, Boone, Pers, Pilotto, López-Ventoso, Diez Valcarce, Zhang and Raat.