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Internet-Based Chronic Disease Self-Management: A Randomized Trial
Abstract
BACKGROUND: The small-group Chronic Disease Self-Management Program (CDSMP) has proven effective in changing health-related behaviors and improving health statuses. An Internet-based CDSMP was developed to reach additional chronic-disease patients. OBJECTIVES: We sought to determine the efficacy of the Internet-based CDSMP. DESIGN: We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year. SUBJECTS: Nine-hundred fifty-eight patients with chronic diseases (heart, lung, or type 2 diabetes) and Internet and e-mail access were randomized to intervention (457) or usual care control (501). MEASURES: Measures included 7 health status variables (pain, shortness of breath, fatigue, illness intrusiveness, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 3 utilization variables (physician visits, emergency room visits, and nights in hospital), and self-efficacy. RESULTS: At 1 year, the intervention group had significant improvements in health statuses compared with usual care control patients. The intervention group had similar results to the small-group CDSMP participants. Change in self-efficacy at 6 months was found to be associated with better health status outcomes at 1 year. CONCLUSIONS: The Internet-based CDSMP proved effective in improving health statutes by 1 year and is a viable alternative to the small-group Chronic Disease Self Management Program.
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“We found attrition risk of bias in 7 studies that presented a high risk regarding incomplete data [48,51,56-58,60,61].”
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Metadata
- Authors
- Lorig, K. R., Ritter, P. L., Laurent, D. D., & Plant, K.
- Affiliations
- Stanford Medicine (US)
- Venue
- Medical Care
- Published
- 2006-11
- Volume
- 44
- Issue
- 11
- Pages
- 964-971
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W2043770015
- Cited by
- 450
- References
- 30
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 15 · 2022: 12 · 2021: 18 · 2020: 8 · 2019: 17 · 2018: 17 · 2017: 25 · 2016: 26 · 2015: 34 · 2014: 33 · 2013: 43 · 2012: 32
- FWCI
- 20.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- Chronic Disease Self-Management Program, online intervention, chronic disease self-management, health behavior change, health status outcomes, self-efficacy, type 2 diabetes, heart disease, lung disease, physical activity, stress management, physician communication, health care utilization, email
- MeSH terms
- Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Follow-Up Studies, Health Status Indicators, Humans, Male, Middle Aged, Surveys and Questionnaires, Self Care, Time Factors, Health Behavior, Outcome Assessment, Health Care, Self Efficacy, Internet
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