Chapter 1. Introduction
Design and Evaluation of Three Administration on Aging (AoA) Programs: Chronic Disease Self-Management Program Evaluation Design (continued)
Chronic Disease Self-Management Programs (CDSMPs) are designed to empower adults with chronic disorders to better self-manage their conditions and improve their physical and mental health. The best known and most thoroughly studied CDSMP was developed by the Division of Family and Community Medicine, Stanford University School of Medicine, with funding from the Agency for Healthcare Research and Quality (AHRQ) and the State of California Tobacco-Related Diseases office. This lay-led program emphasizes the individual's role in managing illness and building self-efficacy so that he or she can be successful in adopting healthy behaviors. The Administration on Aging (AoA) funds the CDSMP and similar programs through grants to State Units on Aging and Public Health Departments, which disburse funding to local Area Agencies on Aging (AAAs) in many states.
The Stanford University CDSMP is an evidence-based disease prevention model designed to help people with chronic diseases better self-manage their conditions, improve their health status, and reduce their need for more costly medical care. The program consists of 2.5-hour workshops once a week for 6 weeks and is generally administered in community settings such as churches, libraries, YW/MCAs, senior centers, public housing projects, community health centers, and cooperative extension programs. The program is also available online in some areas. Because the program is not disease-specific, people with different chronic health problems attend together. The workshops are facilitated by two leaders, who are trained and certified by Stanford University, one or both of whom are non-health professionals or lay people with chronic diseases themselves. Workshop topics include: (1) appropriate exercise for maintaining and improving strength, flexibility, and endurance; (2) appropriate use of medications; (3) communicating effectively with health professionals; (4) nutrition; and (5) techniques to deal with problems such as frustration, fatigue, pain, and isolation.
The goal of the project task is to design an evaluation that examines the effectiveness of the Stanford University CDSMP, as administered by the AoA, in improving participant health status, health behavior, self-efficacy, quality of life (QOL) outcomes, cognitive symptom management, and reducing health care utilization and costs.
Our evaluation recommendations will be derived from four sources: a literature review of chronic disease self-management programs; a review of CDSMP program materials provided by AoA and the National Council on Aging (NCOA); telephone interviews with staff of CDSMP grantees (State aging and/or public health departments) in Michigan, Illinois, and North Carolina and with staff of host sites within those states; and written and verbal feedback from a three‐member technical expert panel (TEP). Findings from each of these approaches will help clarify conceptual and methodological issues with implications for the design and execution of the evaluation.
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