title: Building skill in heart failure self-care among community dwelling older adults: results of a pilot study.
abstract: OBJECTIVE
  Most of the day-to-day care for heart failure (HF) is done by the patient at home and requires skill in self-care. In this randomized controlled trial (RCT) we tested the efficacy of a community-based skill-building intervention on HF self-care, knowledge and health-related quality of life (HRQL) at 1- and 3-months.
  
  
  METHODS
  An ethnically diverse sample (n=75) of patients with HF (53% female; 32% Hispanic, 27% Black; mean age 69.9±10 years) was randomized to the intervention group (IG) or a wait-list control group (CG). The protocol intervention focused on tactical and situational HF self-care skill development delivered by lay health educators in community senior centers. Data were analyzed using mixed (between-within subjects) ANOVA.
  
  
  RESULTS
  There was a significant improvement in self-care maintenance [F(2,47)=3.42, p=.04, (Cohen's f=.38)], self-care management [F(2,41)=4.10, p=.02, (Cohen's f=.45) and HF knowledge [F(2,53)=8.00, p=.001 (Cohen's f=.54)] in the IG compared to the CG.
  
  
  CONCLUSIONS
  The skill-building intervention improved self-care and knowledge but not HRQL in this community-dwelling sample.
  
  
  CONCLUSIONS
  Delivering an intervention in a community setting using lay health educators provides an alternative to clinic- or home-based teaching that may be useful across diverse populations and geographically varied settings.
authors.affiliation: College of Nursing, New York University, New York, USA. Electronic address: vdickson@nyu.edu.
authors.forename: Victoria Vaughan
authors.initials: VV
authors.lastname: Dickson
authors.affiliation: College of Nursing, New York University, New York, USA.
authors.forename: Gail D'Eramo
authors.initials: GD
authors.lastname: Melkus
authors.affiliation: School of Medicine, New York University, New York, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Katz
authors.affiliation: College of Nursing, New York University, New York, USA.
authors.forename: Alissa
authors.initials: A
authors.lastname: Levine-Wong
authors.affiliation: College of Nursing, New York University, New York, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Dillworth
authors.affiliation: College of Nursing, New York University, New York, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013663:Teaching
keywords: Health educators; Heart failure; Self-care; Symptom monitoring decision-making; Treatment adherence