scholarly journals PROMOTING SUCCESSFUL CHRONIC DISEASE SELF-MANAGEMENT THROUGH COMMUNITY-BASED INTERVENTIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S68-S69
Author(s):  
Tiffany R Washington ◽  
Laura N Gitlin ◽  
Matthew L Smith
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Health Management ◽  
Negative Impact ◽  
Self Management ◽  
Community Based Interventions ◽  
Community Based ◽  
Factors Affecting ◽  
Management Interventions

Abstract Persistent chronic conditions are among the top leading causes of death in the U.S. The majority of older adults live with two or more chronic conditions. When poorly managed, chronic conditions can result in negative psychosocial and health outcomes such as low quality of life, diminished mood, workforce withdrawal, high healthcare utilization, and disability. Fortunately, chronic disease self-management interventions show promise in reducing the negative impact of chronic conditions on health status. This symposium will highlight formative work and recent findings of community-based interventions that promote successful self-management. To start, presenter one will describe findings from four studies that constitute the formative work necessary to inform implementation of self-management interventions in community and healthcare settings. Next, presenter two will report findings from an effectiveness trial of a technology-based intervention to support hypertension self-management. Then, presenter three will describe findings on the feasibility of a Health Passport tool to promote self-health management among individuals with physical limitations. Finally, presenter four will describe factors affecting attendance among African Americans with arthritis who participated in a national dissemination of Chronic Disease Self-Management Education programs. Collectively, these presentations will provide practical evidence and science-based recommendations for ways to increase successful chronic disease self-management and ultimately improve population health among older adults.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

Life-balance self-management programme for community-based older adults living with chronic disease: a feasibility study

2016 ◽  
Vol 4 (3) ◽  
pp. 459 ◽  
Author(s):  
Beverley Ann Burrell ◽  
Jennifer Jordan ◽  
Marie Crowe ◽  
Amanda Wilkinson ◽  
Jonathan Williman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Chronic Disease ◽  
Management Programme ◽  
Self Management ◽  
Community Based ◽  
Life Balance ◽  
Term Condition

Rationale, aims and objectives: Health management strategies are aimed at promoting self-management, healthy lifestyle choices to improve health status and quality of life while addressing cost-effectiveness in health services. We aimed to develop a Life-balance Self-management Programme (LBSP) to test whether taking a trans-diagnostic approach to education combined with presenting mindfulness concepts would enhance self-management with older people with at least one long term condition. This study aimed to test the feasibility of the LBSP in terms of its recruitment strategies, suitability of data collection tools and procedures and if it was acceptable to those receiving it via surveys. Methods: The study utilized a descriptive pre/post-test intervention design. Participants sought were community-based older adults (aged 65+) living with at least one long-term condition and resident in Canterbury, New Zealand. The data analysis was descriptive, correlation between baseline and follow-up were determined.Results: Participants (n=10) reported that they had learnt from the intervention, had adjusted approaches for healthier living and improved self-managing skills. Nil attrition supported the feasibility and acceptability of the intervention.A high correlation was found between measures taken at baseline and at 3 month post-intervention, suggesting meaningful change could be detected within a modest sample size. Conclusion The LBSP, based on empirical and theoretical knowledge, is feasible for trans-diagnostic groups of community-based older adults living with chronic disease. A larger intervention study is planned to test quality of life and functioning as the main outcomes of the programme promoting self-management and to adequately assess effectiveness

Barriers to Physical Activity Following Rehabilitation: Perspectives of Older Adults with Chronic Disease

2016 ◽  
Vol 24 (2) ◽  
pp. 223-233 ◽  
Author(s):  
Laura Desveaux ◽  
Roger Goldstein ◽  
Sunita Mathur ◽  
Dina Brooks
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Case Manager ◽  
Physical Symptoms ◽  
Group Differences ◽  
Program Participation ◽  
Community Based ◽  
Exercise Participation ◽  
Barriers To Exercise

Nonadherence to exercise is a main cause of reduced function for older adults with chronic disease following completion of rehabilitation. This quantitative study used a questionnaire to evaluate the barriers and facilitators to community-based exercise following rehabilitation, from the perspectives of older adults with chronic diseases and their healthcare professionals (HCPs). Questionnaires were administered one-on-one to 83 older adults and 35 HCPs. Those with chronic disease perceived cost (43%), travel time (43%), and physical symptoms (39%) as primary barriers to program participation, with similar perceptions across all chronic conditions. Access to a case manager (82%), a supported transition following rehabilitation (78%), and a condition-specific program (78%) were the primary facilitators. Significant between group differences were found between HCPs and older adults with chronic disease across all barriers (p < .001), with a greater number of HCPs perceiving barriers to exercise participation. There were no between-group differences in the perception of factors that facilitate participation in exercise.

scholarly journals Development of a Smartphone Application for the Treatment of Chronic pain in Older adults based on the Daily life experience of Pain Ecological monitoring and management app for chronic pain in older adults - EMMA: Protocol for the EMMA design and feasibility study (Preprint)

2021 ◽  
Author(s):  
Katharina Ledermann
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Older People ◽  
Chronic Conditions ◽  
Daily Life ◽  
Ecological Monitoring ◽  
Cognitive Behavioral ◽  
Self Management ◽  
Trial Period ◽  
Management Interventions

BACKGROUND Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy (CBT) is recommended for older people with chronic pain. However, online treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. OBJECTIVE To address this problem, we will develop a psychological internet-based intervention based on ecological monitoring of daily life experiences with chronic pain, called EMMA to support self-management of chronic pain in older adults. METHODS The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a CoDesign approach and actively involves the end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user centered intervention design. For the CoDesign process, we will include 10 older adults without chronic pain that will discuss the requirements in workshops in order to ensure suitability for older adults. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain that will test all features of the intervention for a period of eight consecutive weeks. After the trial period, validated instruments to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms will be filled out by the participants. Participants will be invited to take part in a semi-structured telephone interview after the trial period to explore their experiences using the app. Required changes to assure usability and acceptability will afterwards directly implemented in the application. RESULTS EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention irrespective of place and time to target chronic pain in older adults. CONCLUSIONS Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored pain self-management interventions.

scholarly journals Interventions to Support Behavioral Self-Management of Chronic Diseases

2019 ◽  
Vol 40 (1) ◽  
pp. 127-146 ◽  
Author(s):  
John P. Allegrante ◽  
Martin T. Wells ◽  
Janey C. Peterson
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Health Care Expenditures ◽  
Self Management ◽  
Management Interventions ◽  
Wide Range

A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

Patients’ Perceptions of Integrated Care Among Medicare Beneficiaries by Level of Need for Health Services

2022 ◽  
pp. 107755872110678
Author(s):  
Nancy Song ◽  
Molly Frean ◽  
Christian T. Covington ◽  
Maike Tietschert ◽  
Emilia Ling ◽  
...  
Keyword(s):  
Integrated Care ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Health Management ◽  
Least Square ◽  
Sensitivity Analyses ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Factors Affecting ◽  
Ordinary Least Square Regression

Requirements for integrating care across providers, settings, and over time increase with patients’ needs. Health care providers’ ability to offer care that patients experience as integrated may vary among patients with different levels of need. We explore the variation in patients’ perceptions of integrated care among Medicare beneficiaries based on the beneficiary’s level of need using ordinary least square regression for each of four high-need groups: beneficiaries (a) with complex chronic conditions, (b) with frailties, (c) below 65 with disability, and (d) with any (of the first three) high needs. We control for beneficiary demographics and other factors affecting integrated care, and we conduct sensitivity analyses controlling for multiple individual chronic conditions. We find significant positive associations with level of need for provider support for self-directed care and medication and home health management. Controlling for multiple individual chronic conditions reduces effect sizes and number of significant relationships.

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