title: Qualitative exploration of rural focus group members' participation in the Chronic Disease Self-Management Program, USA.
abstract: BACKGROUND
  Nearly half of rural residents in the USA have at least one chronic condition, and meeting the complex needs of these individuals has become a challenge for the current healthcare system. A self-management approach enables individuals with chronic illnesses to gain skills needed to improve the management of their conditions. Rural areas have a higher proportion of individuals who are likely to be affected by chronic conditions. Based on these factors, it is necessary to provide programs to help rural residents self-manage their health. The purpose of this qualitative, exploratory study is to explore the benefits perceived by rural residents due to their participation in six weekly group sessions, which are referred to as the Chronic Disease Self-Management Program (CDSMP).
  
  
  METHODS
  Individuals who completed the CDSMP were recruited to participate in a focus group regarding their experience with the program. Thirty-four of the 45 respondents (75%) who completed the CDSMP participated in six focus groups. When the respondents returned for the scheduled focus groups, they were asked to share their experience with the CDSMP. Each focus group was located at the same site that housed the program in their community. Phenomenological and consensual qualitative approaches were used in the data analysis for the present study.
  
  
  RESULTS
  The majority (91%) of the participants were female. Of those, 97% were non-Hispanic whites. The mean number of chronic conditions was two, with a range between one and eight chronic conditions per participant. Two prominent themes emerged from the six focus groups: respondent interaction in behavior change and prioritizing health behavior change.
  
  
  CONCLUSIONS
  The study findings support that chronic disease self-management programs can initiate positive behavioral changes, and those lifestyle changes can influence and improve the health of rural populations. Similar programs can yield beneficial results on important behavior change for the rural communities, an underserved population with chronic conditions.
authors.affiliation: Department of Human Development and Family Studies, University of Connecticut, Storrs, USA. idethia.harvey@uconn.edu.
authors.forename: I S
authors.initials: IS
authors.lastname: Harvey
authors.affiliation: East Carolina University, Greenville, North Carolina, USA. jankem@ecu.edu.
authors.forename: M
authors.initials: M
authors.lastname: Janke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D012648:Self Care / Q000379:methods* / Q000523:psychology
keywords: Education; Public Health; Qualitative Research