Stanford University, Palo Alto, CA 94306, USA.
Health Educ Behav. 2013 Feb;40(1):67-77. doi: 10.1177/1090198112436969. Epub 2012 Apr 4.
To evaluate the effectiveness of an online chronic disease self-management program for South Australia residents.
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.
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, self-efficacy, and visits to emergency departments remained significant. Satisfaction with health care trended toward significance.
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.
评估南澳大利亚居民在线慢性病自我管理计划的效果。
数据在基线、6 个月和 12 个月时在线收集。干预措施是提供在线异步 6 周的慢性病自我管理计划。作者测量了 8 项健康状况指标、7 项行为和 4 项利用指标；自我效能感；以及医疗保健满意度。
254 名有 1 种或多种慢性病的南澳大利亚成年人完成了基线数据。144 人完成了 6 个月，194 人完成了 12 个月。在 6 个月时，有 4 项健康状况指标、6 项健康行为、自我效能感和急诊就诊次数显著改善（p<.05）。在 12 个月时，五项健康状况指标、六项健康行为、自我效能感和急诊就诊仍然显著。对医疗保健的满意度呈显著趋势。
基于同伴的在线计划对该人群是可接受和有用的。它似乎可以减轻症状、改善健康行为、自我效能感，并降低医疗保健利用率，长达 1 年。这种干预措施对于利用公共健康教育模式来覆盖大量人群也具有重要意义。它表明，包括社交媒体在内的互联网自我管理计划可以覆盖农村和服务不足的人群，并且有效且降低医疗成本。如果这种干预措施能够扩大规模，它有可能改善大量慢性病患者的生活。它代表了医疗保健和公共卫生部门可以互动的一种方式。
