A Feasibility Study of Low-Income Homebound Older Adults’ Participation in an Online Chronic Disease Self-Management Program

Introduction Promoting older adults to self-manage their chronic conditions is a major focus of the Macao government and healthcare professionals since more than 80% of older adults have suffered chronic conditions. Objectives This study evaluated the effect of the Chronic Disease Self-management Program (CDSMP) on self-management behaviors, self-efficacy, health status, and healthcare services utilization among Macao older adults with chronic disease over six months, and assessed whether the intervention effect persisted for one year. Methods A longitudinal and quasi-experimental design was used in this study. A total number of 158 older adults with at least one chronic disease were recruited from three Macao community centers. Participants in the study group engaged in a six-session CDSMP in the community centers and participants in the control group received usual care. The Chronic Disease Self-management Questionnaire was used to assess the outcome measures for baseline, six-month and one-year assessment. Results The age of subjects ranged from 60 to 88, 64.6% had three or more chronic diseases. The results showed that the subjects in the study group had significant improvement in self-management behaviors, self-efficacy, and some health-related indicators at the point of six months, and these improvements were still observable at the point of one year when comparing to the control group. The results also showed that the study group had a decrease in healthcare services utilization, but there was no significant difference between the two groups. Conclusion This study confirmed that the community-dwelling older adults in Macao can acquire positive outcomes in self-management and health-related indicators from the CDSMP. Hence, it is worth promoting this program as a health promotion activity in community.

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Effects of the Chronic Disease Self-Management Program on medication adherence among older adults

Translational Behavioral Medicine ◽

10.1093/tbm/iby057 ◽

2018 ◽

Vol 9 (2) ◽

pp. 380-388 ◽

Cited By ~ 2

Author(s):

Shinduk Lee ◽

Luohua Jiang ◽

Diane Dowdy ◽

Y Alicia Hong ◽

Marcia G Ory

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Medication Adherence ◽

Management Program ◽

Self Management

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A Feasibility Study of Multi-Component Fall Prevention for Homebound Older Adults Facilitated by Lay Coaches and Using a Tablet-Based, Gamified Exercise Application

Journal of Applied Gerontology ◽

10.1177/0733464821991024 ◽

2021 ◽

pp. 073346482199102

Author(s):

Namkee G. Choi ◽

Emma Stanmore ◽

Julieta Caamano ◽

Kelly Vences ◽

Nancy M. Gell

Keyword(s):

Older Adults ◽

Feasibility Study ◽

Low Income ◽

Fall Prevention ◽

Prevention Program ◽

Physical Therapist ◽

Mobility Limitations ◽

Fall Prevention Program ◽

Ambulation Training ◽

Homebound Older Adults

Although homebound older adults face high risk for falls, they are unable to utilize community-based fall prevention programs due to their mobility limitations. In this article, we report a feasibility study of a four-session, multicomponent fall prevention program for low-income homebound older adults using pre, post, mixed-method design. The manualized program was delivered by lay coaches who were trained and supervised by a physical therapist. The program also used an iPad-based gamified strength and balance exercise app (called KOKU) that was operable without the need to connect to the internet. Participants ( N = 28) in this study were highly receptive to the program and approved all components: psychoeducation, the KOKU app, home-safety checks, safe ambulation training, and medication review. The study showed that a brief, multi-component fall prevention program for homebound older adults is feasible and acceptable. Further research is needed to evaluate its effectiveness.

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THE EFFECTIVENESS OF THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM AMONG AT-RISK OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igx004.4991 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 1358-1358

Author(s):

O. Yulikova

Keyword(s):

Older Adults ◽

At Risk ◽

Chronic Disease ◽

Management Program ◽

Self Management

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Using the Replicating Effective Programs Framework to Adapt a Heart Health Intervention

Health Promotion Practice ◽

10.1177/1524839918775740 ◽

2018 ◽

Vol 20 (5) ◽

pp. 760-769 ◽

Cited By ~ 2

Author(s):

Jessica E. Ramsay ◽

Mary R. Janevic ◽

Cainnear K. Hogan ◽

Dominique L. Edwards ◽

Cathleen M. Connell

Keyword(s):

Older Adults ◽

Heart Disease ◽

Chronic Disease ◽

Low Income ◽

The United States ◽

Lessons Learned ◽

Self Management ◽

Management Support ◽

Management Intervention ◽

Effective Programs

Heart disease is the leading cause of death in the United States. African Americans and people of low socioeconomic status suffer disproportionately from heart disease–related morbidity and mortality. In Detroit, Michigan, a primarily African American and low-income urban area, heart disease mortality is at twice the national rate. Despite evidence for the effectiveness of self-management support interventions in reducing chronic disease burden for older adults, few are adapted for communities most in need. This article describes the process of adapting Take PRIDE, an evidence-based heart disease self-management intervention, for older adults in Detroit via the Replicating Effective Programs (REP) framework. Working within a community–academic partnership, we found REP useful in facilitating the identification of diverse stakeholders, core versus adaptable elements of the intervention and barriers to implementation. We also made several modifications to the REP framework in order to better fit our project needs. Overall, we found REP to be an effective, flexible tool that allowed us to successfully adapt a disease-management intervention for this setting. Processes, lessons learned, and recommendations offered in this article may help researchers and practitioners working to expand access to self-management support for populations most affected by chronic disease.

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