Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial.
OBJECTIVE
To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program (CDSMP).


METHODS
A randomized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment (waiting-list controls) in five urban communities in Shanghai, China. Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately; those in the control group received the same education and book six months later.


RESULTS
In total, 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension, heart disease, chronic lung disease, arthritis, stroke, or diabetes who lived in communities were assigned randomly to treatment (n = 526) and control (n = 428) groups. Overall, 430 (81.7%) and 349 (81.5%) patients in the treatment and control groups completed the six-month study. Patients who received treatment had significant improvements in weekly minutes of aerobic exercise, practice of cognitive symptom management, self-efficacy to manage own symptoms, and self-efficacy to manage own disease in general compared with controls. They also had significant improvements in eight indices of health status and, on average, fewer hospitalizations.


CONCLUSIONS
When implemented in Shanghai, the CDSMP was acceptable culturally to Chinese patients. The programme improved participants' health behaviour, self-efficacy, and health status and reduced the number of hospitalizations six months after the course. The locally based delivery model was integrated into the routine of community government organizations and community health services. Chinese lay leaders taught the CDSMP courses as successfully as professionals.
Fu
Dongbo
D
School of Public Health, Fudan University, Shanghai, People's Republic of China.
Fu
Hua
H
McGowan
Patrick
P
Shen
Yi-e
YE
Zhu
Lizhen
L
Yang
Huiqin
H
Mao
Jianguo
J
Zhu
Shitai
S
Ding
Yongming
Y
Wei
Zhihua
Z
D000368:Aged; D002681:China; D002908:Chronic Disease / Q000628:therapy*; D003153:Community Health Services; D003466:Cultural Characteristics; D019468:Disease Management; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012648:Self Care