title: 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.
  
  
  OBJECTIVE
  We sought to determine the efficacy of the Internet-based CDSMP.
  
  
  METHODS
  We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
authors.affiliation: Stanford University School of Medicine, Stanford, California 94306, USA.
authors.forename: Kate R
authors.initials: KR
authors.lastname: Lorig
authors.forename: Philip L
authors.initials: PL
authors.lastname: Ritter
authors.forename: Diana D
authors.initials: DD
authors.lastname: Laurent
authors.forename: Kathryn
authors.initials: K
authors.lastname: Plant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013997:Time Factors