The South Australia Health Chronic Disease Self-Management Internet Trial

• Published in: Health education & behavior Vol. 40; no. 1; pp. 67 - 77
• Main Authors: Lorig, Kate, Ritter, Philip L., Plant, Kathryn, Laurent, Diana D., Kelly, Pauline, Rowe, Sally
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.02.2013; Sage Publications; SAGE PUBLICATIONS, INC
• Subjects: Adult; Adults; Aged; Australia; Behavioral Risk Factor Surveillance System; Biological and medical sciences; Chronic Disease - psychology; Chronic Disease - therapy; Chronic Illness; Chronic illnesses; Chronic sickness; Clinical trials; Disease management; Education; Effectiveness studies; Emergency Service, Hospital - utilization; Female; Foreign Countries; Health Behavior; Health behaviour; Health care; Health Conditions; Health Education; Health Services; Health Status; Hospitals; Humans; Internet; Intervention; Male; Measures (Individuals); Medical sciences; Medical Services; Middle Aged; Miscellaneous; Online Courses; Patient Education as Topic - methods; Peer Teaching; Prevention and actions; Program Effectiveness; Program Evaluation; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Self Care - methods; Self Care - psychology; Self Care - statistics & numerical data; Self Efficacy; Self Management; Selfefficacy; Selfmanagement; South Australia; Symptoms (Individual Disorders); Australia; Oceania; South Australia; South Australia Australia; Australia, South Australia; self-tailoring; Internet; self-management; chronic disease; Chronic; Selfcare; Chronic disease; Customization; Clinical trial; Management; Self; Health education; Public health
• ISSN: 1090-1981; 1552-6127
• DOI: 10.1177/1090198112436969

Objectives. To evaluate the effectiveness of an online chronic disease self-management program for South Australia residents. Method. Data were collected online at baseline, 6 months, and 12 months. The intervention was an asynchronous 6-week chronic disease self-management program offered online. The authors measured eight health status measures, seven behaviors, and four utilization measures; self-efficacy; and health care satisfaction. Results. Two hundred fifty-four South Australian adults with one or more chronic conditions completed baseline data. One hundred forty-four completed 6 months and 194 completed 1 year. Significant improvements (p < .05) were found at 6 months for four health status measures, six health behaviors, self-efficacy, and visits to emergency departments. At 12 months, five health status indicators, six health behaviors, selfefficacy, and visits to emergency departments remained significant. Satisfaction with health care trended toward significance. Discussion. The peer-led online program was both acceptable and useful for this population. It appeared to decrease symptoms, improve health behaviors, self-efficacy, and reduce health care utilization up to 1 year. This intervention also has large potential implications for the use of a public health education model for reaching large numbers of people. It demonstrates that an Internet self-management program, which includes social media, can reach rural and underserved people as well as be effective and reduce health care costs. If this intervention can be brought to scale, it has the potential for improving the lives of large numbers of people with chronic illness. It represents a way the medical care and public health sectors can interact.