title: Self-management programs conducted within a practice setting: who participates, who benefits and what can be learned?
abstract: OBJECTIVE
  To investigate the impact of generic and diabetes-specific self-management programs offered in a real world context.
  
  
  METHODS
  A quasi-experimental design with 12-week follow-up compared Living with a Chronic Condition and Living with Diabetes. Self-report data collected included: Self-management Knowledge and Skills; Health Related Quality of Life (HRQOL); Depression; Social Isolation; Loneliness; Self-efficacy; and Health Behaviours.
  
  
  RESULTS
  Participants (N=458) in the two programs differed on almost all baseline measures. Both demonstrated statistically significant improvements in Self-management Knowledge and Skills, as well as reductions in depression. In addition to younger age, low HRQOL, high self-efficacy and Positive and Active Engagement in Life, were the clinical factors most likely to lead to improvements in HRQOL and self-efficacy. Changes in different characteristics predicted different outcomes.
  
  
  CONCLUSIONS
  Both generic and disease-specific programs led to improved outcomes, despite the two programs attracting significantly different participants. Referral patterns also differed but GP referral rates were low for both.
  
  
  CONCLUSIONS
  Positive participant outcomes can be achieved in real life clinical settings. While younger people with a positive attitude may appear to gain more, it is important to encourage people from low socio-economic status to enter these programs so that social inequalities in health are not worsened.
authors: School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada. Tanya.Packer@dal.ca
authors: Tanya L
authors: TL
authors: Packer
authors: Duncan
authors: D
authors: Boldy
authors: Setareh
authors: S
authors: Ghahari
authors: Lauren
authors: L
authors: Melling
authors: Richard
authors: R
authors: Parsons
authors: Richard H
authors: RH
authors: Osborne
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome