 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Virginia Nodhturft, Ed D, Department of Nursing Education, James A. Haley Veterans' Hospital, 13000 Bruce B. Downs Blvd., 118m, Tampa, FL 33612 and Nakki Price, MPH, University of South Florida, 8623 Cattail Drive, Tampa, FL 33637, 813-984-6993, skybluez13@hotmail.com.
This presentation will communicate the outcomes that were achieved by implementing a new community based Chronic Disease Self-Management Program (CDSMP) in the Veterans Health Administration (VHA). This program was one of ten innovations selected by VHA as a Best Practice Model out of 250 submissions.
This was a prospective, randomized controlled clinical trial of 214 veterans, men and women, with physician confirmed diagnosis of diabetes, and who are cognitively intact. The outcomes that were measured were health behaviors, self-efficacy, health status and health care utilization were measured using self-rated scales developed and tested by Lorig and colleagues from Stanford University.
The long-term objectives were three-fold: 1) to increase veterans’ recognition of patient responsibility for health 2) develop more effective skills in participating and managing their chronic conditions 3) to explore the role of self-efficacy in facilitating improvements in health behaviors and health care utilization. This unique program utilizing peer leaders maximized the health potential of veterans by enabling veterans to help themselves regain or maintain the highest level of independence and functioning as possible.
The intervention was a seven-week program taught in pairs of trained leaders in community –based sites. Between 10-15 veterans attended each program. The CDSMP curriculum included: physical activity, cognitive symptom management, problem solving, communication (with family, friends and provider), use of medication, and dealing with the emotions of chronic illness (anger, frustration & depression). The sessions were highly interactive, with emphasis on efficacy-enhancing strategies.
The strategies used in the self-management program were seen as having a major impact on positive outcomes for the veteran subjects, with several components showing statistical significance. It was concluded that our study provided insight to the role that self-efficacy plays in helping veterans take greater responsibility for their health, whether the intervention increases health behaviors among veterans with diabetes, and whether changes in health care utilization can impact on cost savings.
This material is based upon work supported by the Office of Research and Development, Health Services Research and Development, and the Department of Veterans Affairs.
Learning Objectives:
Keywords: Chronic Diseases, Veterans' Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.