Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting

• Published in: The Gerontologist Vol. 48; no. 5; pp. 698 - 705
• Main Authors: Gitlin, Laura N, Chernett, Nancy L, Harris, Lynn Fields, Palmer, Delores, Hopkins, Paul, Dennis, Marie P
• Format: Journal Article
• Language: English
• Published: United States Gerontological Society of America 01.10.2008
• Subjects: African Americans; Aged; Aged, 80 and over; Chronic Disease - ethnology; Chronic Disease - therapy; Chronic Illness; Comparative Analysis; Disease Control; Diseases; Female; Humans; Interviews; Interviews as Topic; Male; Middle Aged; Older Adults; Participation; Physicians; Program Development; Program Effectiveness; Program Evaluation; Residential Facilities; Self Care; Self Efficacy; Theory Practice Relationship
• ISSN: 0016-9013
• DOI: 10.1093/geront/48.5.698

Purpose: We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants. Design and Methods: Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews. Results: A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed less than or equal to 4 sessions and 414 (79%) completed pre-post interviews. We found small but statistically significant improvements for exercise (p = 0.001), use of cognitive management strategies (p = 0.001), energy/fatigue (p = 0.001), self-efficacy (p = 0.001), health distress (p = 0.001), and illness intrusiveness in different life domains (probabilities from 0.001- 0.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site. Implications: The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities.