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.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL038083-04
Application #
3354110
Study Section
Special Emphasis Panel (SRC (LC))
Project Start
1988-03-01
Project End
1993-01-31
Budget Start
1991-03-01
Budget End
1993-01-31
Support Year
4
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Type
Schools of Public Health
DUNS #
791277940
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
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Wheeler, John R C; Janz, Nancy K; Dodge, Julia A (2003) Can a disease self-management program reduce health care costs? The case of older women with heart disease. Med Care 41:706-15
Forthofer, M S; Janz, N K; Dodge, J A et al. (2001) Gender differences in the associations of self esteem, stress and social support with functional health status among older adults with heart disease. J Women Aging 13:19-37
Janz, N K; Janevic, M R; Dodge, J A et al. (2001) Factors influencing quality of life in older women with heart disease. Med Care 39:588-98
Clark, N M; Janz, N K; Dodge, J A et al. (2000) Changes in functional health status of older women with heart disease: evaluation of a program based on self-regulation. J Gerontol B Psychol Sci Soc Sci 55:S117-26
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Janz, N K; Clark, N M; Dodge, J A et al. (1999) The impact of a disease-management program on the symptom experience of older women with heart disease. Women Health 30:1-24
Clark, N M; Janz, N K; Dodge, J A et al. (1994) Managing heart disease: a study of the experiences of older women. J Am Med Womens Assoc 49:202-6
Clark, N M; Janz, N K; Becker, M H et al. (1992) Impact of self-management education on the functional health status of older adults with heart disease. Gerontologist 32:438-43
Sharpe, P A; Clark, N M; Janz, N K (1991) Differences in the impact and management of heart disease between older women and men. Women Health 17:25-43