Self-management In Adults Research Articles

Self-management behavior and its influencing factors among adults with chronic obstructive pulmonary disease in Colombo, Sri Lanka: A cross-sectional study.

Self-management behaviors are essential to take care of chronic obstructive pulmonary disease (COPD). However, data on COPD self-management practices in Sri Lankan adults is limited. Therefore, identifying the level of COPD self-management and examining its influencing factors are essential for healthcare providers to manage COPD effectively. This research aimed to describe the level of self-management behaviors and determine whether dyspnea, perceived stress, COPD knowledge, and social support can predict self-management in adults with COPD in Colombo, Sri Lanka. A predictive correlational study was conducted, and 108 adults with mild to moderate COPD were recruited from the central chest clinic in Colombo, Sri Lanka, from March to April 2024 using a simple random sampling technique. A self-administered questionnaire was used to gather data included demographic characteristics. The other instruments used were the COPD Self-Management Scale, the Perceived Stress Scale, the COPD Knowledge Questionnaire, and the Perceived Social Support Scale. Descriptive statistics and multiple regression were used for data analysis. The study showed a moderate self-management level with a mean of 3.04 ± 0.35. All variables could explain 41.7% of the variance in self-management among adults with mild to moderate COPD and COPD self-management behaviors significantly predicted by dyspnea (β = 0.212, p = 0.006), perceived stress (β = -0.195, p = 0.018), COPD knowledge (β = 0.263, p = 0.001), and perceived social support (β = 0.366, p <0.001). The study shows evidence that a program to intervene targeting COPD knowledge and perceived social support, in addition to reducing dyspnea and perceived stress, can be beneficial in promoting better self-management behaviors among adults with mild to moderate COPD.

Assessing the impact of the iPeer2Peer program for adolescents with juvenile idiopathic arthritis: a mixed-methods randomized controlled trial

BackgroundJuvenile Idiopathic Arthritis (JIA) is a chronic pediatric illness, whereby youth experience physical, emotional and psychosocial challenges that result in reduced health related quality of life (HRQL). Peer mentoring has been shown to improve disease self-management in adults with chronic conditions, with mixed results in younger populations. Building on our pilot work – which supported the feasibility and initial effectiveness of the iPeer2Peer program – the objective of this study was to assess the clinical effectiveness of the program in youth with JIA through a waitlist randomized controlled trial.MethodsEighty-one youth (aged 12–18) were randomized to the intervention group and matched with trained peer mentors (18–25 years; successfully managing their JIA), completing of up to ten 30-min video calls over a 15-week period. Eighty-three youth in the control group received standard care. Outcome assessments occurred at enrollment, 15 weeks post randomization and 6-months post randomization. The primary outcome was self-management, measured using the TRANSITION-Q. Secondary outcomes were HRQL, pain, emotional distress, disease knowledge, self-efficacy, and perceived social support. These were assessed using linear mixed effects models. Content analysis of semi-structured interviews and focus groups was used to assess satisfaction with the program with mentors and mentees upon study completion.ResultsIn total, 164 youth (mean age 14.4 ± 1.9 years, 78% female) were randomized to the study. The proposed sample size was not reached due to challenges in recruitment, likely impacted by the COVID-19 pandemic. The iPeer2Peer program did not show significant improvement in self-management (p = 0.7), or any of the secondary outcomes. Three key categories emerged from content analysis: (1) Fulfillment and Support Through Shared Experience, (2) Enhancing Program Delivery and (3) Strategies to Boost Engagement. These findings highlight that mentees valued the ability to converse with mentors who empathized with their disease experience, while mentors found it fulfilling to support mentees, and noted that they could have benefited from this type of support themselves.ConclusionWhile the iPeer2Peer did not result insignificant changes in clinical outcomes, both mentors and mentees were satisfied with the program and felt that mentorship provided real-world benefits for disease management and overall wellbeing.Trial registrationClinicalTrials.gov, NCT03116763. Registered 31, March 2017, https://www.clinicaltrials.gov/study/NCT03116763

Factors Associated With Self-management in Adults With Type 1 or Type 2 Diabetes

Background Poor self-management in adults with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) leads to increased diabetes complications. Factors associated with self-management in T1DM and T2DM may differ due to the different methods for controlling blood glucose. Purpose The aim of this study was to examine the associations of modifiable physical, cognitive, and psychosocial factors and the nonmodifiable factor of age with overall self-management, diet, exercise, blood glucose testing (BGT), foot care, and smoking in adults with T1DM or T2DM. Methods In this cross-sectional, correlational study, data were collected from adults with T1DM (n = 64; mean age, 51.2 years) or T2DM (n = 84; mean age, 62.5 years) using REDCap in 2023 and were analyzed using multiple regression analyses. Results Older age, lower body mass index, and stronger knowledge in T1DM (F 10,53 = 2.290, P = .026, R 2 = 0.302), and lower body mass index and higher levels of self-efficacy in T2DM were associated with better overall self-management (F 10,73 = 3.219, P = .002, R 2 = 0.306). Different combinations of age, body mass index, knowledge, resilience, and self-esteem were associated with different components of self-management, including diet, BGT, and foot care, in T1DM, whereas different combinations of body mass index, knowledge, self-efficacy, and depressive symptoms were associated with different components of self-management, including diet, exercise, and BGT, in T2DM. Conclusions Factors associated with self-management differed based on types of diabetes and components of self-management. Clinicians need to consider the 2 types of diabetes and distinct factors associated with each component of self-management to improve it.

Supporting self-management in adults after stroke - synthesis of qualitative studies

Supporting self-management in adults after stroke - synthesis of qualitative studies

Promoting Self-Management in Adults With Type 2 Diabetes: Development of the Impact of Glucose Monitoring on Self-Management Scale

ObjectivesType 2 diabetes (T2D) management requires behavioural engagement to achieve optimal outcomes and continuous glucose monitoring (CGM) technologies may facilitate self-management. In this study, we describe the development and validation of a self-report instrument, the Impact of Glucose Monitoring on Self-Management Scale (IGMSS), assessing the impact of device use (primarily CGM but also self-monitored blood glucose [SMBG]) on the capability, motivation, and opportunity to engage in self-management. MethodsPotential items were generated from 3 sources: themes and quotes from 13 adults with T2D motivated by CGM use who participated in a qualitative study; behaviour change theory identifying capability, opportunity, and motivation to self-manage; and expert committee review of items. An initial pool of 42 items were generated describing CGM as promoting personalized knowledge, improved health (Capability), improved relationships, having positive device characteristics (Opportunity), and improved engagement in self-management (Motivation). Based on expert committee consensus, items were written so as to be completed by those using any glucose-sensing device (SMBG and CGM). Psychometric evaluation was conducted with 514 English-speaking Canadians. Scale reduction (22 final items) was completed using item-response distribution, internal consistency, factor analysis, and expert opinion. Construct and convergent validity were evaluated using the Impact of Glucose Monitoring Satisfaction Scale, the Diabetes Self-Management Questionnaire, the Diabetes Distress Scale, the 5-item World Health Organization Well-Being Index, and the Centre for Epidemiology Depression Scale. Test–retest reliability was determined for 130 participants. ResultsInternal consistency was high for all scales, ranging from 0.73 to 0.91. Test–retest reliability ranged from 0.58 to 0.79, except for Device Characteristics. Construct and convergent validity indices were acceptable. There was substantial overlap between the IGMSS and established measures of CGM satisfaction. IGMSS findings were also predictive of self-management behaviour and emotional functioning. ConclusionsThe IGMSS has positive psychometric characteristics and has the potential to screen people with T2D for engagement in diabetes self-management using CGM or any sensing device. Scores can be determined for various aspects of Capability (Personalized Knowledge, Improved Health), Opportunity (Relationships and Device Characteristics), and Motivation.

Telehealth Behavioral Intervention for Chronic Disease Self-Management in Adults With Physical Disabilities (My Health, My Life, My Way): Protocol for Intervention Fidelity and Dashboard Design for a Randomized Controlled Trial.

Individuals with physical disabilities experience higher rates of chronic health conditions than individuals without physical disabilities. Self-management programs that use health coaching are effective at eliciting health behavior change in health outcomes such as goal setting, adherence, and health care use. Additionally, web-based resources such as telehealth-based technologies, including SMSS text messaging, web-based applications, and educational multimedia content, can complement health coaching to improve health-related behaviors and the use of health services. The complexity of studies using these resources requires a fidelity protocol to ensure that health behavior studies are administered properly. The My Health, My Life, My Way fidelity protocol provides methods, strategies, and procedures of a multifaceted telehealth program for individuals with permanent physical disabilities and chronic health conditions. This health behavior study is a randomized controlled trial with four study arms: (1) scheduled coaching calls with gamified rewards, (2) no scheduled coaching calls with gamified rewards, (3) scheduled coaching calls with fixed rewards, and (4) no scheduled coaching calls with fixed rewards. To guide the fidelity protocol developed, we used the National Institutes of Health Behavior Change Consortium framework (NIH BCC). The fidelity intervention protocol was developed by using the 5 primary domains provided by the NIH BCC: study design, provider training, treatment delivery, treatment receipt, and enactment of treatment skills. Following the NIH BCC guidelines and implementing social cognitive theory, this study is designed to ensure that all study arms receive equal treatment across conditions and groups. Health coaches and providers will be trained to deliver consistent health coaching, and thus participants will receive appropriate attention. Educational content will be developed to account for health literacy and comprehension of the material. Multiple fidelity intervention steps such as coaching call logs, regular content review, and participant progress monitoring will translate to participants using the skills learned in their daily lives. Different monitoring steps will be implemented to minimize differences among the 4 treatment groups. My Health, My Life, My Way has been approved by the institutional review board and will begin enrollment in January 2024 and end in December 2024, with results reported in early 2025. Intervention fidelity protocols are necessary to ensure that health behavior change studies can be implemented in larger real-world settings. The My Health, My Life, My Way fidelity protocol has used the guidelines by the NIH BCC to administer a telehealth intervention combined with health coaching for individuals with physical disabilities and chronic health conditions. This fidelity protocol can be used as a complementary resource for other researchers who conduct similar research using telehealth technologies and health coaching in real-world settings. ClinicalTrials NCT05481593; https://clinicaltrials.gov/study/NCT05481593. PRR1-10.2196/53410.

Diabetes self-management by Kenyan adults: Utilising the adapted Kawa River model

The outcome of diabetes management depends on diabetes self-management practices, in which factors assisting or hindering self-care play an essential role. This study identified enablers and barriers to diabetes self-management in adults diagnosed with diabetes in Kenya. The adapted Kawa River model was applied to collect data during semi-structured group discussions (n = 6). Adults (n = 32) diagnosed with diabetes at two geographically distinct county hospitals were purposively selected. The integrated model of behaviour prediction formed the theoretical platform of the study, and data were deductively analysed according to the distal variables in the model. Thematic analysis identified specific categories as enablers and barriers to diabetes self-management. The duplicated categories are economic determinants, dietary factors, support networks, and emotional influences. Health and physical status were identified as additional barriers to diabetes self-management. Findings may be more widely applicable than the context of the presented study. Self-management in diabetes care plays a crucial role, more so due to the worldwide increase in the prevalence of diabetes.

Effectiveness of the Nurse-led Self and Family Management Support Program among Adults with Early-stage Chronic Kidney Disease: A Randomized Controlled Trial

Chronic kidney disease is a significant health problem that leads to severe complications and premature death. Adults with early-stage chronic kidney disease need to maintain renal function and prevent the progression, which can be achieved through effective self-management. This randomized control trial with a two-arm pre-post-test aimed to investigate the effectiveness of the Nurse-led Self and Family Management Support Program for increasing disease knowledge and self-management among adults with early-stage chronic kidney disease. The sample consisted of dyads of 64 adults with the disease and their family members. The dyads were randomly assigned to the experimental arm (n = 32) and the control arm (n = 32). The experimental arm received the Nurse-led Self and Family Management Support Program, while the control arm received only usual care. Data was collected using a demographic data recording form, the Disease Knowledge Scale, and the Chronic Kidney Disease Self-Management Scale. Data analysis was undertaken using descriptive statistics, two-way repeated ANOVA with post hoc test, and independent t-test. From the results, the participants in the experiment arm had better disease knowledge and self-management than the control group at 4, 8, and 12 weeks after the program and were better than before the program. Nurses can apply this program to encourage individuals and family members to be involved in providing all aspects of support for self-management for adults with early-stage chronic kidney disease. However, further testing in other settings is needed.

Impact of Fatigue and Its Influencing Factors on Diabetes Self-Management in Adults With Type 2 Diabetes: A Structural Equation Modeling Analysis.

The purposes of this study were to (1) examine the relationships between fatigue, its influencing factors, and diabetes self-management and (2) test the mediation effects of fatigue on the link between the influencing factors and diabetes self-management in adults with type 2 diabetes. This cross-sectional, correlational study was guided by the theory of unpleasant symptoms. Data were collected using structured questionnaires. Fatigue was measured by the Fatigue Symptom Inventory and the Multidimensional Fatigue Inventory. Diabetes self-management was measured by the Summary of Diabetes Self-Care Activities. From March to July 2021, a convenience sample of 150 participants was recruited from 2 diabetes outpatient clinics of a regional hospital in Taiwan. Data were analyzed using structural equation modeling. A more recent diagnosis of diabetes, more depressive symptoms, and lower sleep quality were related to higher fatigue. Higher fatigue correlated with less performance in diabetes self-management. Fatigue mediated the relationship between depressive symptoms, sleep quality, and diabetes self-management. Fatigue had a mediating effect on the link between psychological influencing factors and diabetes self-management. Future development of fatigue interventions integrating depressive symptoms and sleep management will likely increase the performance of diabetes self-management and improve the health outcomes in adults with type 2 diabetes. The study tested the theory of unpleasant symptoms using empirical data and will assist in building theory-guided fatigue interventions to improve diabetes self-management in people with type 2 diabetes.

Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases

BackgroundSelf-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases.MethodsUsing a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management.ResultsParticipants’ mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1–5 varied from 2.61 to 3.24 (possible score 1–4); domains 6–9 from 3.29 to 3.65 (possible score 1–5). The mean scores were 52.7 (SD = 10.4, possible score 0–95), 5.46 (SD = 1.9, possible score 0–10) and 82.1 (SD = 12.4, possible score 30–120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support.ConclusionsDeveloping critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.

Evaluation of a Group-based Patient Education Program Promoting Self-management in Adults with Hirschsprung Disease and Anorectal Malformations

IntroductionAdults with Hirschsprung disease (HD) and anorectal malformations (ARM) may experience persisting and new somatic and psychosocial problems. Patient education programs (PEPs) may improve self-management in patients with chronic illnesses. The aim of this study was to explore HD and ARM adults’ experiences with and evaluation of a group-based PEP. We also looked at factors that might influence the attendance rate. MethodNon-intellectually impaired HD and ARM adults were invited to attend a diagnosis specific PEP at a pelvic floor interdisciplinary center. Eight health care professionals lectured. Aspects of the PEP were graded anonymously in a patient reported experience measure (PREM). Ethical approval was obtained. Results17% (21/125) of invited adults (10HD, 11ARM) attended four PEPs. 19/21 (90%) PREMs were returned. Participants found meeting peers and sharing experiences especially valuable in addition to improved disease knowledge. Lectures by the pediatric and colorectal surgeons, stoma nurse, and sexologist were rated highest by the participants. The majority reported that the PEP would be helpful in managing everyday life. All participants recommended PEP in adolescence. Factors such as gender and travel distance did not affect attendance rate, but participants were older than non-participants, median 37 versus 24 years (p = 0.01). ConclusionAttendance rates were low among HD and ARM adults invited to a PEP, but participants were overall highly satisfied. Peer support, mutual learning, and increased disease knowledge were seen as invaluable assets of the PEP. A web-based PEP was discouraged, while physical PEPs for both adults and adolescents were encouraged. Level of EvidenceIII.

Medication self-management interventions for persons with stroke: A scoping review.

The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.

The management of chronic pain in sickle cell disease: an interview with Nadine Matthie.

Nadine Matthie, PhD, RN, CNL is an Assistant Professor in the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta, GA, USA. As a nurse scientist, she has conducted behavioral research to investigate pain and self-management in adults living with sickle cell disease, and address chronic, non vaso-occlusive pain in this population. DrMatthie is developing nonpharmacological, patient-centered, self-management strategies that incorporate virtual reality and biopsychosocial approaches to help manage chronic pain and reduce the burden of sickle cell;thereby, facilitating new, personalized approaches to management of chronic pain conditions in the home setting. Her research has been published in several national and international peer-reviewed sources for various disciplines, including nursing, medicine, music therapyand psychology.

Self-management in adults after solid-organ transplantation: a scoping review protocol

IntroductionAfter solid-organ transplantation (SOTx), recipients must adhere to a lifelong medical regimen, change their lifestyle and cope with physiological and psychosocial challenges. This requires active participation in their care and...

Usability Experience of a Personal Sleep Monitoring Device to Self-manage Sleep Among Persons 65 Years or Older With Self-Reported Sleep Disturbances.

Increasingly, persons with self-reported health symptoms are using mobile health technologies to better understand, validate, and manage their symptoms. These off-the-shelf devices primarily utilize actigraphy to estimate sleep and activity. The purpose of this study was to describe qualitatively the experience of using a personal sleep monitoring device for sleep self-management in adults 65 years or older with self-reported sleep disturbances. This study followed a hybrid qualitative design using deductive and emergent coding derived from open-ended interviews (n = 25) after a period of 4 weeks using a wearable personal sleep monitoring device. Results expanded existing theoretical models on usability with the theme of personal meaning in the interaction between health and self-monitoring technology that were associated with age and technology use, privacy, and capability. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring devices should continue to collect qualitative information in extending the understanding of user experience across different symptom clusters, such as sleep disturbances, that manifest more commonly in older age populations. This research is important for application in the use of mobile health technologies for nursing led health self-management interventions.

Usability Experience of a Personal Sleep Monitoring Device to Self-manage Sleep Among Persons 65 Years or Older With Self-reported Sleep Disturbances.

Increasingly, persons with self-reported health symptoms are using mobile health technologies to better understand, validate, and manage their symptoms. These off-the-shelf devices primarily utilize actigraphy to estimate sleep and activity. The purpose of this study was to describe qualitatively the experience of using a personal sleep monitoring device for sleep self-management in adults 65 years or older with self-reported sleep disturbances. This study followed a hybrid qualitative design using deductive and emergent coding derived from open-ended interviews (n = 25) after a period of 4 weeks using a wearable personal sleep monitoring device. Results expanded existing theoretical models on usability with the theme of personal meaning in the interaction between health and self-monitoring technology that were associated with age and technology use, privacy, and capability. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring devices should continue to collect qualitative information in extending the understanding of user experience across different symptom clusters, such as sleep disturbances, that manifest more commonly in older age populations. This research is important for application in the use of mobile health technologies for nursing led health self-management interventions.

A digital approach to asthma self-management in adults: Protocol for a pragmatic randomized controlled trial

Asthma self-management can improve symptom control, but adherence to established self-management behaviors is often poor. With adult asthma uncontrolled in over 60% of U.S. cases, there is a need for scalable, cost-effective tools to improve asthma outcomes. Here we describe a protocol for the Asthma Digital Study, a 24-month, decentralized, pragmatic, open-label, randomized controlled trial investigating the impact of a digital asthma self-management (DASM) program on asthma outcomes in adults. The program leverages consumer-grade devices with a smartphone app to provide “smart nudges,” symptom logging, trigger tracking, and other features. Participants are recruited (target N = 900) from throughout the U.S., and randomized to a DASM or control arm (1:1). Co-primary outcomes at one year are a) asthma-associated costs for acute care and b) change from baseline in Asthma Control Test™ scores. Findings may inform decisions around adoption of digital tools for asthma self-management.Trial registration:clinicaltrials.gov identifier: NCT04609644. Registered: Oct 30, 2020.

EFFECTIVENESS E-HEALTH TO SELF MANAGEMENT OF DIABETES MELLITUS TYPE 2 : LITERATURE REVIEW

Introduction: Patient and nurse is constructive relationship beneficial in a self-management support approach. Research shows e-health intervention has the potential to support self-management for adults with type 2 diabetes. The purpose this article to apply the application of e-health to people with type 2 diabetes mellitus. Method: Method is search journal articles through basic data in ProQuest, Clinical key, EBSCO with a time span of 2018-2022, using the keywords "e-health intervention" and "diabetes mellitus type 2". The number of related articles is 10 journals. Results: Results the literature review conducted showed that e-health has an effective and efficient impact on self-management in patients with type 2 diabetes mellitus, nurses can find time to find out the progress of people with diabetes mellitus, reduce the incidence of diabetes and complications. Conclusion: Conclusion the use of e-health in self-management of people with diabetes mellitus has provided positive benefits for the development and improvement of service quality for the community. Health is a new medium in health services that requires broader knowledge and more in-depth practice, so the use of digital media in management needs to conduct further research in the focus of research on health. Keywords: e-health, self-management, diabetes mellitus.

COPD Self-Management for Adults Living in Rural Areas: Systematic Review of Telehealth and Non-Telehealth Interventions

ABSTRACT Background Chronic Obstructive Pulmonary Disease (COPD) is more prevalent in rural areas than in non-rural areas due to factors such as limited access to healthcare; however, no known studies have systematically reviewed evidence related to the impact of self-management interventions on rural adults with COPD. Purpose Systematically review telehealth and non-telehealth self-management interventions delivered to adults with COPD in rural areas. Methods Six electronic databases were searched to identify eleven eligible articles. Results Six studies delivered telehealth interventions, while five delivered non-telehealth interventions. Six interventions (54.5%) reported the use of a behavioral theory, and four (36.4%) employed a randomized control trial (RCT) design. Three studies (n = 2 telehealth; n = 1 non-telehealth) reported significant improvements in self-management efficacy, five (n = 3 telehealth; n = 2 non-telehealth) reported improvements in quality of life, four (n = 1 telehealth; n = 3 non-telehealth) demonstrated improved exercise capacity, and four (n = 2 telehealth; n = 2 non-telehealth) reported improved COPD knowledge. Discussion There is promising evidence that telehealth interventions could be as beneficial as non-telehealth interventions for improving COPD self-management in rural areas. Translation to Health Education Practice: Community-based needs assessments in rural areas may help determine the optimal method of delivery (i.e., telehealth and/or non-telehealth strategies) for local COPD self-management interventions. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Modelling Successful Self-Management in Adults With Cystic Fibrosis: Vicarious Self-Efficacy From Videos of ‘People Like Me’

BackgroundSelf-efficacy is an important determinant of treatment adherence, and peer modelling of success can provide vicarious self-efficacy. A series of patient stories (‘talking heads’ videos) were developed with people with cystic fibrosis (CF) as part of the CFHealthHub multi-component adherence intervention, aiming to demonstrate success with daily therapy in ‘people like me’.MethodologyOne-to-one semi-structured interviews exploring patients’ experiences, barriers and facilitators of nebuliser adherence were audio and video-recorded between October 2015 and August 2016. Interview transcripts were reviewed to identify descriptions of problem-solving and sustained treatment success. Positive stories potentially providing vicarious descriptions of success were selected as video clips.ResultsIn total, 14 adults with CF were recruited from five UK CF centres. Each participant contributed a median of five (interquartile range: 3-6) video clips, and a total of 57 unique clips were uploaded onto the CFHealthHub digital platform. Nine of those clips spanned two categories, hence, there were 66 clips across 16 categories.ConclusionsThe videos were well received though some adults were concerned that comparisons with peers might create anxiety by highlighting the possibility of future decline or current relative underperformance. It is important to sensitively support choice when providing resources aiming to increase vicarious self-efficacy. Our experience may guide the development of similar videos for people with other long-term conditions.