title: Adapting Stanford's Chronic Disease Self-Management Program to Hawaii's multicultural population.
abstract: OBJECTIVE
  Stanford's Chronic Disease Self-Management Program (CDSMP) has been proven to increase patients' ability to manage distress. We describe how we replicated CDSMP in Asian and Pacific Islander (API) communities.
  
  
  METHODS
  We used the "track changes" tool to deconstruct CDSMP into its various components (e.g., recruitment and staffing) and the "adaptation traffic light" to identify allowable modifications to the original program. We monitored local leaders' fidelity of delivery of CDSMP and tracked participants' attendance, satisfaction, and 6-month outcomes.
  
  
  RESULTS
  Between July 2007 and February 2010, 584 completed a CDSMP workshop. Baseline and 6-month data were available for 422 (72%), including 53 Caucasians, 177 Asians, and 194 Pacific Islanders. All 3 groups realized significant decreases in social and role activity limitations and significant increases in communication with physicians. Asians and Pacific Islanders also realized significant increases in self-rated health and time spent engaging in stretching/strengthening exercise. Asians also reported significant reductions in health distress and self-reported physician visits and increases in time spent in aerobic exercise, ability to cope with symptoms, and self-efficacy.
  
  
  CONCLUSIONS
  Our experience suggests that CDSMP can be modified for increased cultural appropriateness for API communities while maintaining the key components responsible for behavior change.
authors: MS, Office of Public Health Studies, University of Hawaii at Mānoa, 1960 East-West Road, Biomed D-209, Honolulu, HI 96822, USA. mtomioka@hawaii.edu
authors: Michiyo
authors: M
authors: Tomioka
authors: Kathryn L
authors: KL
authors: Braun
authors: Merlita
authors: M
authors: Compton
authors: Leslie
authors: L
authors: Tanoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology*; D002908:Chronic Disease / Q000628:therapy*; D018864:Cultural Diversity; D055317:Evidence-Based Practice; D005260:Female; D006254:Hawaii; D006801:Humans; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data