title: A meta-analysis of health status, health behaviors, and health care utilization outcomes of the Chronic Disease Self-Management Program.
abstract: The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions; it has been implemented worldwide. The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program's effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline.
  
  
  
  We searched 8 electronic databases to identify CDSMP-relevant literature published from January 1, 1999, through September 30, 2009; experts identified additional unpublished studies. We combined the results of all eligible studies to calculate pooled effect sizes. We included 23 studies. Eighteen studies presented data on small English-speaking groups; we conducted 1 meta-analysis on these studies and a separate analysis on results by other delivery modes.
  
  
  
  Among health behaviors for small English-speaking groups, aerobic exercise, cognitive symptom management, and communication with physician improved significantly at 4- to 6-month follow-up; aerobic exercise and cognitive symptom management remained significantly improved at 9 to 12 months. Stretching/strengthening exercise improved significantly at 9 to 12 months. All measures of psychological health improved significantly at 4 to 6 months and 9 to 12 months. Energy, fatigue, and self-rated health showed small but significant improvements at 4 to 6 months but not at 9 to 12 months. The only significant change in health care utilization was a small improvement in the number of hospitalization days or nights at 4 to 6 months
  
  
  
  Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that CDSMP delivered in small English-speaking groups produces health benefits for participants and would be a valuable part of comprehensive chronic disease management strategy.
authors: Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. tob9@cdc.gov
authors: Teresa J
authors: TJ
authors: Brady
authors: Louise
authors: L
authors: Murphy
authors: Benita J
authors: BJ
authors: O'Colmain
authors: Danielle
authors: D
authors: Beauchesne
authors: Brandy
authors: B
authors: Daniels
authors: Michael
authors: M
authors: Greenberg
authors: Marnie
authors: M
authors: House
authors: Doryn
authors: D
authors: Chervin
mesh_terms: D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D010353:Patient Education as Topic; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods*