This project proposes to evaluate the effectiveness of a self-management program tailored to the particular needs of older women with heart disease. The program will be assessed in terms of this impact on women's health-related quality of life, principally psychosocial and physical functioning and use of health services. The education is based on social cognitive theory, especially the construct of self-regulation. Participants will be assisted to work individually to address problems in carrying out specific heart management recommendations of their physicians. Special emphasis will be given to the need to maintain adequate levels of physical activity. They will receive instruction in a group format which provides for efficiency of teaching and the use of social influences and models of behavior. Participants will be referred by their physicians and the program will operate in concert with the health-care provider. A randomized design will be used to test the program with 630 women sixty years of age or older. Psychosocial and physical functioning will be measured by the Sickness Impact Profile, the Women's Heart Self-Management Index, and objective evaluations of mobility and exercise capacity. Health service use will be measured using physician and hospital records. The program will be evaluated to assess the impact of education over time. A program specifically tailored to women's needs and organized around the context of their illness, and home management roles should have a significant impact on their psychosocial and physical functioning.
