A secondary objective was to determine whether program effect differed by delivery mode. We examined changes in health behaviors, physical and psychological health status (including self-efficacy), and health care utilization reported in CDSMP studies in English-speaking countries.
The primary objective of this meta-analysis was to determine the short-term (4–6 months) and longer-term (9–12 months) effect of the Stanford CDSMP. Previous meta-analyses of chronic disease self-management programs suggest they offer modest health benefits (10–12), but these analyses combined multiple types of self-management programs, focused exclusively on randomized controlled trials (RCTs), and examined a limited range of outcomes. Summarizing the effect of CDSMP is difficult with such inconsistencies. For example, Lorig et al reported positive changes in self-rated health but not health distress (7), whereas Barlow et al found the opposite (8) Kennedy et al found positive changes in fatigue and exercise (2), but Goeppinger et al found neither (9). The findings of more recent studies, however, are inconsistent. The original CDSMP validation study found improvements in health status, health behaviors, and health care utilization (1). A Spanish-language version (5) and alternative delivery modes, such as Internet-based “virtual” small-group classes (6), are also available. Developed at Stanford University, the program has been disseminated throughout the United States and worldwide (1–4). It is taught by trained leaders who follow a structured protocol and given to participants who have various chronic conditions (1). The Chronic Disease Self-Management Program (CDSMP) is a 6-week community-based, self-management education program designed to help participants gain the confidence (self-efficacy) and skills to better manage their chronic conditions. Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that CDSMP delivered in small English-speaking groups produces health benefits for participants and would be a valuable part of comprehensive chronic disease management strategy. The only significant change in health care utilization was a small improvement in the number of hospitalization days or nights at 4 to 6 months Energy, fatigue, and self-rated health showed small but significant improvements at 4 to 6 months but not at 9 to 12 months. All measures of psychological health improved significantly at 4 to 6 months and 9 to 12 months. Stretching/strengthening exercise improved significantly at 9 to 12 months. Eighteen studies presented data on small English-speaking groups we conducted 1 meta-analysis on these studies and a separate analysis on results by other delivery modes.Īmong health behaviors for small English-speaking groups, aerobic exercise, cognitive symptom management, and communication with physician improved significantly at 4- to 6-month follow-up aerobic exercise and cognitive symptom management remained significantly improved at 9 to 12 months. We combined the results of all eligible studies to calculate pooled effect sizes. We searched 8 electronic databases to identify CDSMP-relevant literature published from January 1, 1999, through Septemexperts identified additional unpublished studies.
The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program’s effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline.
The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions it has been implemented worldwide. A Meta-Analysis of Health Status, Health Behaviors, and HealthĬare Utilization Outcomes of the Chronic Disease Self-Management Program. Suggested citation for this article: Brady TJ, Murphy L, O’Colmain BJ, Beauchesne D, Daniels B, Greenberg M, et al. O’Colmain, MPH Danielle Beauchesne, MPH Brandy Daniels, MPH Michael Greenberg, JD, MPH Marnie House, EdD, MPH Doryn Chervin, DrPH, MEd
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