This application is aimed at evaluating different health education approaches to improve the health-related quality of life and health care utilization of older women with heart disease. Approximately 1,100 women, who are 60 to 80 years old and have coronary heart disease, will be randomized to one of four treatment conditions: 1) usual care control, 2) group-based health education, 3) self-directed education via mail and phone contacts, or 4) a choice of either the self-directed or group program. The programs will be evaluated at 3, 12, and 18 months. The primary outcomes of interest are physical and psychological functioning, frequency and severity of symptoms, and health care utilization. It is hypothesized that both the self-directed and group health education formats will result in better long-term outcomes than usual care, and that the best outcomes will be observed when women are given a choice between either of the formats.
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