title: Determining the efficacy of the chronic disease self-management programme and readability of 'living a healthy life with chronic conditions' in a New Zealand setting.
abstract: BACKGROUND
  Self-management programmes are an increasingly popular way of treating chronic diseases.
  
  
  OBJECTIVE
  This study aims to determine the efficacy of the Stanford Chronic Disease Self-Management Programme (CDSMP) in a New Zealand context by assessing course outcomes and readability of the accompanying reference guide Living a Healthy Life with Chronic Conditions, 4th Edition.
  
  
  METHODS
  This is a cross-sectional pre-post study conducted in Auckland between August 2009 and September 2015, using CDSMP participants' baseline and follow-up Health Education Intervention Questionnaire (heiQTM) data. Readability of the guide was assessed using the Gunning Fog Index, Coleman Liau, Flesch Reading Ease, Flesch Kincaid Grade Level and Simplified Measure of Gobbledygook scores.
  
  
  RESULTS
  Significant evidence of improvement (P ≤ 0.001) was observed in seven of the eight domains measured by the heiQTM(Deakin University, Centre for Population Health Research, Melbourne, Vic., Australia). The greatest improvements were seen in skill and technique acquisition (mean change score 0.25, P ≤ 0.001) and self-monitoring and insight (0.18, P ≤ 0.001). There was little evidence of improvement in health service navigation (0.04, P = 0.17). Readability analyses indicate that a person needs to be reading at a minimum of U.S. 8th grade level in order to understand the text, and possibly up to 11th grade.
  
  
  CONCLUSIONS
  The CDSMP is effective for improving patient self-efficacy in the New Zealand setting. However, adaptation of the programme to support better health service navigation is warranted. The readability of the reference guide is not suitable for this setting and requires further improvement.
authors: Faculty of Medical and Health Sciences, Discipline of Nutrition/Dietetics, The University of Auckland, Auckland, New Zealand.
authors: J J-Y
authors: JJ
authors: Cheng
authors: ProCare Health, Patient Services, Auckland, New Zealand.
authors: F
authors: F
authors: Arenhold
authors: Faculty of Medical and Health Sciences, Discipline of Nutrition/Dietetics, The University of Auckland, Auckland, New Zealand. a.braakhuis@auckland.ac.nz.
authors: A J
authors: AJ
authors: Braakhuis
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D032882:Comprehension; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D057220:Health Literacy / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012648:Self Care; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: 
  heiQTM
  
  ; chronic disease; readability; self-efficacy; self-management