title: Harvest health: translation of the chronic disease self-management program for older African Americans in a senior setting.
abstract: OBJECTIVE
  We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants.
  
  
  METHODS
  Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews.
  
  
  RESULTS
  A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed >/=4 sessions and 414 (79%) completed pre-post interviews. We found small but statistically significant improvements for exercise (p =.001), use of cognitive management strategies (p =.001), energy/fatigue (p =.001), self-efficacy (p =.001), health distress (p =.001), and illness intrusiveness in different life domains (probabilities from.001-.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site.
  
  
  CONCLUSIONS
  The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities.
authors.affiliation: Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, PA 19107, USA. laura.gitlin@jefferson.edu
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Chernett
authors.forename: Lynn Fields
authors.initials: LF
authors.lastname: Harris
authors.forename: Delores
authors.initials: D
authors.lastname: Palmer
authors.forename: Paul
authors.initials: P
authors.lastname: Hopkins
authors.forename: Marie P
authors.initials: MP
authors.lastname: Dennis
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D012112:Residential Facilities; D012648:Self Care