We propose to examine the effectiveness of a self-management program (""""""""take PRIDE"""""""") for older people with heart disease in enhancing their functional health status and reducing health-care utilization. The """"""""take PRIDE"""""""" program, based on social learning theory, aims to increase the participants' repertoire of self- management skills by introducing them to a problem-solving system for reducing obstacles to carrying out the regimen prescribed by their physicians. We also intend to examine the role of self-efficacy in the older person's attempts to reduce management problems. The study will be conducted in four hospitals and employs a pretest-posttest control group design. A total of 600 elderly cardiac patients will be randomly assigned to """"""""usual care"""""""" or to """"""""usual care plus self-management program."""""""" Telephone interviews and chart review will be conducted to assess functional status, medicine-taking behavior, and psychosocial factors. Health-care utilization will be determined from review of hospital computerized data and from patient charts. The study is unique in that it: (a) focuses on the elderly person as the manager of chronic disease; (b) centers on a major cause of morbidity in the elderly; (c) systematically involves relatives who provide assistance to the elderly patients; and (d) enables the patient to resolve specific problems in carrying out his or her particular regimen. If study hypotheses are supported, the program would represent an easy-to-implement intervention that improves quality of life and health status, and engenders important health care savings. The study will also examine the theoretical construct of self-efficacy, investigating the interactions of self-efficacy, self-management, and education based on social learning theory.
