title: Meeting the challenge of cancer survivorship in public health: results from the evaluation of the chronic disease self-management program for cancer survivors.
abstract: BACKGROUND
  Self-management has been identified as an important opportunity to improve health outcomes among cancer survivors. However, few evidence-based interventions are available to meet this need.
  
  
  METHODS
  The effectiveness of an adapted version of the Chronic Disease Self-Management Program for cancer survivors called Cancer Thriving and Surviving was evaluated in a randomized trial. Outcomes were assessed at baseline and 6-months post program via written survey among 244 participants in Colorado. Repeated measures analysis was used to analyze pre/post program change.
  
  
  RESULTS
  Statistically significant improvement was observed among those in the intervention in the following outcomes: Provider communication (+16.7% change); depression (-19.1%); energy (+13.8%); sleep (-24.9%) and stress-related problems (-19.2%); change over time was also observed in the controls for energy, sleep, and stress-related outcomes though to a lesser degree. Effect sizes of the difference in change over time observed indicate a net beneficial effect for provider communication (0.23); and decreases in depression (-0.18); pain (-0.19); problems related to stress (-0.17); and sleep (-0.20).
  
  
  CONCLUSIONS
  Study data suggest that the self-management support from adaptation of the CDSMP can reach and appeal to cancer survivors, improves common concerns in this population, and can fill an important gap in meeting the ongoing need for management of post-diagnosis issues in this growing segment of the U.S. population.
authors.affiliation: Community and Behavioral Health, Colorado School of Public Health , Aurora, CO , USA.
authors.forename: Betsy C
authors.initials: BC
authors.lastname: Risendal
authors.affiliation: Community and Behavioral Health, Colorado School of Public Health , Aurora, CO , USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dwyer
authors.affiliation: Carilion Clinic, Virginia Tech Carilion School of Medicine , Roanoke, VA , USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Seidel
authors.affiliation: School of Medicine, Stanford University , Stanford, CA , USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
authors.affiliation: Colorado Health Outcomes, University of Colorado , Aurora, CO , USA.
authors.forename: Letoynia
authors.initials: L
authors.lastname: Coombs
authors.affiliation: Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health , College Station, TX , USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
keywords: cancer survivorship; community-based research; effectiveness trial; patient education; self-management support