Health benefits of teaching rural people with disabilities to use community resources for health management compared with health education: A randomized trial

Self-management is a key strategy for addressing the complex health needs of many adults with disabilities. Unfortunately, self-management resources (e.g., fitness centers) in rural areas are fewer and dispersed geographically, which necessitates they be used as efficiently as possible. One strategy in emerging medical practice to improve self-management is Self-Management Support (SMS). This strategy supports individuals to achieve their health goals by facilitating the effective and efficient use of existing health management resources. We recruited eight Centers for Independent Living serving rural areas and randomly assigned the Centers to implement either an SMS intervention focused on health management goals and community resource identification or to a standard health education intervention on physical activity, nutrition and maintaining health behavior change. These centers recruited 41 consumers (20 treatment, 21 control) who completed the intervention, pre, post, and 3-month follow-up self-report measures. Results indicated that both experimental and control participants made statistically significant (α < .05) improvements from pre- to post-test on the Health Promoting Lifestyle Inventory-II, Secondary Conditions and participation operationalized as excursions into the community. At follow-up, control participants returned to baseline on all measures while treatment participants maintained treatment gains on HPLP-II. Further analysis indicated that 19 of 40 participants were in the path of Hurricane Sandy between the post-test and follow-up, which may have affected treatment outcomes on Secondary Conditions. Results will be discussed in terms of the health benefits and potential protective effects of helping people identify community resources prior to the onset of a natural disaster.