MS, Office of Public Health Studies, University of Hawaii at Mānoa, 1960 East-West Road, Biomed D-209, Honolulu, HI 96822, USA.
Gerontologist. 2012 Feb;52(1):121-32. doi: 10.1093/geront/gnr054. Epub 2011 Jun 30.
Stanford's Chronic Disease Self-Management Program (CDSMP) has been proven to increase patients' ability to manage distress. We describe how we replicated CDSMP in Asian and Pacific Islander (API) communities.
We used the "track changes" tool to deconstruct CDSMP into its various components (e.g., recruitment and staffing) and the "adaptation traffic light" to identify allowable modifications to the original program. We monitored local leaders' fidelity of delivery of CDSMP and tracked participants' attendance, satisfaction, and 6-month outcomes.
Between July 2007 and February 2010, 584 completed a CDSMP workshop. Baseline and 6-month data were available for 422 (72%), including 53 Caucasians, 177 Asians, and 194 Pacific Islanders. All 3 groups realized significant decreases in social and role activity limitations and significant increases in communication with physicians. Asians and Pacific Islanders also realized significant increases in self-rated health and time spent engaging in stretching/strengthening exercise. Asians also reported significant reductions in health distress and self-reported physician visits and increases in time spent in aerobic exercise, ability to cope with symptoms, and self-efficacy.
Our experience suggests that CDSMP can be modified for increased cultural appropriateness for API communities while maintaining the key components responsible for behavior change.
斯坦福慢性病自我管理项目(CDSMP)已被证明可以提高患者应对压力的能力。我们描述了如何在亚裔和太平洋岛民(API)社区中复制 CDSMP。
我们使用“修订”工具将 CDSMP 分解为其各个组成部分(例如,招募和人员配备),并使用“适应信号灯”来确定对原始计划进行允许的修改。我们监测当地领导人对 CDSMP 的交付的保真度,并跟踪参与者的出勤率、满意度和 6 个月的结果。
2007 年 7 月至 2010 年 2 月期间,有 584 人完成了 CDSMP 研讨会。422 人(72%)提供了基线和 6 个月的数据,包括 53 名白种人、177 名亚洲人和 194 名太平洋岛民。所有 3 组在社会和角色活动受限方面都有显著下降,在与医生沟通方面有显著增加。亚洲人和太平洋岛民的自我健康评估以及进行伸展/强化锻炼的时间也有显著增加。亚洲人还报告称,在健康困扰、自我报告的医生就诊次数、有氧运动时间、应对症状的能力和自我效能感方面也有显著减少。
我们的经验表明,CDSMP 可以进行修改,以增加其对亚太裔社区的文化适宜性,同时保持负责行为改变的关键组成部分。