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National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health
Health Care and Aging Studies Branch
Arthritis Program
Mailstop K-51
4770 Buford Highway NE
Atlanta, GA 30341-3724
Phone: 770.488.5464
Fax: 770.488.5964
Email Us |
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CDC-Funded Science
Comparisons of the Outcomes of the Arthritis Self Help Course (ASHC)
and the Chronic Disease Self Management Program (CDSMP) Among People
with Arthritis
Funding Number
S2233-22\23 (UNC)
Project Description
The arthritis-specific Arthritis Self Help Course (ASHC) and the more
generic Chronic Disease Self Management Program (CDSMP) teach
generalizable skills for managing arthritis and other chronic diseases.
In some locations it may be more feasible to combine efforts and offer
the generic course rather than the arthritis-specific program. However
anecdotal evidence has questioned whether people with arthritis obtain
as much benefit from the more generic course as they do the
arthritis-specific course. The primary purpose of this research study
was to examine the effectiveness and acceptability of the ASHC and the
CDSMP among people with arthritis. The North Carolina project focused
primarily on African Americans from 12 eastern North Carolina counties;
rural African Americans had not been included in previous studies of
these two interventions. The results of this research project will be
used to guide arthritis program recommendations on the use of ASHC and
CDSMP to improve the quality of life for people with arthritis.
Key Findings
Effectiveness
- Four months after participation in the programs, both ASHC and
CDSMP produced significant improvements in self-efficacy, aerobic
exercise, stretching and strengthening exercises, and self-reported
health. CDSMP also produced significant improvements in cognitive
symptom management, health distress, disability, and pain. At 12-month follow-up, none of these improvements were maintained in
either group.
- While no changes in health care utilization were significant at
4-month follow-up, at 12-month follow-up, CDSMP participants showed
a significant decrease in physician visits when compared to ASHC
participants.
- Investigators concluded that generic chronic disease self
management programming may be more cost effective than disease
specific programming among persons with substantial comorbidities.
Acceptability
- Pre-testing determined that modest changes were needed in both
programs to make them culturally appropriate. With permission of
Stanford Patent Education Research Center modifications were made to
address cultural barriers to healthy eating, decreases in fat and
salt, communication with health care professionals, faith and
spirituality, and mutual help.
- Community coordinators were essential to reach 365 African
Americans with arthritis. The community coordinator role was more
time intensive than the workshop leader role.
- Males were hard to recruit; most successful strategies involved
working through their wives. This may have been a reflection of
traditional gender roles among older African American couples.
Abstracts, Publications, Presentations
Goeppinger, J., Barnwell, S., and Ensley, D. (2005, November). Effectiveness of disease self-management education for African
Americans with arthritis. Paper presented at the annual meeting
of American College of Rheumatology and Arthritis and Rheumatology
Health Professionals. San Diego, CA.
Fisher, S. (2005, October). Implementing culturally acceptable
disease self-management education with African American communities.
Paper presented at the workshop, Conducting Culturally Competent
Research, sponsored by Center for Innovation in Health Disparities
Research. Chapel Hill, NC.
Goeppinger, J. (2004, November). Arthritis self-management:
Partnering with rural African-American communities. Paper presented
at The Science of Self Management in Chronic Disease Work Group Meeting,
The National Institute of Nursing Research, The National Institutes of
Health, Bethesda, MD.
Goeppinger, J. (2004, October). Arthritis self-management
education: From effectiveness to acceptability (via partnering).
Paper presented at the American College of Rheumatology Pre-Conference
(Economic, Social and Psychological Impact of Arthritis). San Antonio,
TX.
Papers in Process (Tentative authors and titles)
Goeppinger, J., Ensley, Schwartz, T., Armstrong, B., D., Zaenger,
D., Fisher, S., Barnwell, S., Garner, J., Haddock, R., and Moore, A.
Effectiveness of chronic disease self-management education for
African Americans with arthritis
Goeppinger, J., Fisher, S., Harris, D., Ensley, D., Barnwell,
S., Garner, J., and Haddock, R. Recruitment of African Americans
into community-based research: A case study [Accelerating the
reduction of health disparities through culturally sensitive
adaptation of evidence-based practice interventions]
Principal Investigator
Jean Goeppinger, Ph.D., R.N.
University of North Carolina
School of Nursing
jgoeppin@mail.unc.edu
Back to Funded Science
Page last reviewed: June 4, 2008
Page last modified: July 3, 2006
Content Source: Division of
Adult and Community Health,
National Center for Chronic Disease Prevention and Health Promotion |
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