The effect of a community-based group intervention on chronic disease self-management in a vulnerable population

Sophie A. Korenhof, Ellen V. Rouwet, Liset E.M. Elstgeest, Irene N. Fierloos, Siok Swan Tan, Marta M. Pisano-Gonzalez, An L.D. Boone, Yves Marie Pers, Alberto Pilotto, Mónica López-Ventoso, Isabel Diez Valcarce, Xuxi Zhang, Hein Raat*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
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Abstract

Introduction:

Chronic non-communicable diseases (NCDs) are predominantly related to modifiable health behaviors and account for 74% of global deaths at present. Behavior modification through self-management is a strategy to prevent NCDs. Chronic Disease Self-Management Programs (CDSMPs) have demonstrated improvements in health behaviors, health status, and use of healthcare. 

Objective:

We evaluated the effects of a 6-week CDSMP on self-efficacy, health behaviors, mental health, health-related quality of life (HR-QoL), and health responsibilities among vulnerable populations with chronic disease in Europe. 

Methods: 

A prospective cohort study with a 6-month pre-post single-group design was conducted in five European countries. The intervention targeted adults with chronic conditions and low socioeconomic status, as well as their caregivers. The intervention was a 6-week community-based CDSMP in a group setting. Outcomes were measured per self-report questionnaire at baseline and 6-month follow-up: self-efficacy, health behaviors, mental health, HR-QoL, and health responsibilities. 

Results: 

Of 1,844 participants, 1,248 (67.7%) completed follow-up and attended ≥4 sessions. For the chronic condition group, the following outcome measures at follow-up significantly improved compared with baseline (all P < 0.002): self-efficacy (SEMCD-6 6.7 vs. 6.4), mental health (PHQ-8 6.3 vs. 7.0), HR-QoL (SF-12 PCS 42.3 vs. 40.2, SF-12 MCS 42.8 vs. 41.4), health utility (EQ-5D-5L 0.88 vs. 0.86), self-rated health (EQ-5D-5L 67.2 vs. 63.9), communication with healthcare providers (2.28 vs. 2.11), understanding information (3.10 vs. 3.02), number of doctor visits (3.61 vs. 4.97), accident and emergency department visits (0.25 vs. 0.48), total nights in a hospital (0.65 vs. 1.13), and perceived medical errors (19.6 vs. 28.7%). No significant changes were detected in dietary habits, physical activity, substance use, and sleep and fatigue. For caregivers without a chronic condition, only doctor visits significantly decreased (1.54 vs. 2.25, P < 0.001). 

Discussion: 

This CDSMP was associated with improvement in self-efficacy, depression, HR-QoL, and health responsibilities over 6 months in a diverse European population with a chronic condition. However, additional interventions targeting lifestyle risk factors are needed to improve health outcomes.

Original languageEnglish
Article number1221675
JournalFrontiers in Public Health
Volume11
DOIs
Publication statusPublished - 21 Aug 2023

Bibliographical note

Funding Information:
The enhancing health systems sustainability by providing cost-efficiency data of evidenced based interventions for chronic management in stratified population based on clinical and socio-economic determinants of health (EFFICHRONIC) project received funding from the European Union's Health Programme (2014–2020; grant agreement 738127).

Publisher Copyright:
Copyright © 2023 Korenhof, Rouwet, Elstgeest, Fierloos, Tan, Pisano-Gonzalez, Boone, Pers, Pilotto, López-Ventoso, Diez Valcarce, Zhang and Raat.

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