Evaluation of the Online Chronic Disease Self-Management Project at Group Health

• health outcomes [ Time Frame: 6 months and 1 year after the intervention ] [ Designated as safety issue: No ]
  health status; self-efficacy; activities of daily living; symptomatology; mood; weight
  
  

• health care utilization [ Time Frame: 6 months and 1 year after intervention ] [ Designated as safety issue: No ]
  number of physician visits, number of hospitalizations, number of nights in the hospital (all in past 6 months)
  
  
• health behaviors [ Time Frame: 6 months and 1 year after interventio ] [ Designated as safety issue: No ]
  physical activity; stress management; medication adherence; communication with health care team;
  
  

Behavioral: chronic disease self-management program (online)
The online CDSMP is an internet-based program for people with 1 or more chronic conditions. It's built on self-efficacy theory, facilitated by lay leaders, and uses a curriculum emphasizing problem solving, decision making, and confidence building in weekly sessions over six weeks. It addresses generic topics and skills relevant to managing any chronic condition, including: action plans; problem solving; nutrition; exercise; fatigue; breathing; managing medications; managing stress and emotions; working with health care providers. The structure includes: 1) password-protected, interactive web-based instruction; 2) web-based bulletin board discussion groups to enable participatory learning and support; 3) and a reference book that contains the program content and supplemental information.
Other Names:
• Healthier Living with Ongoing Health Problems
• Chronic Disease Self-Management Program

We will pilot an evidence-based online program for chronic disease self-management that is modeled after the widely-replicated in-person Chronic Disease Self-management Program (CDSMP) developed at Stanford University.

The online CDSMP is an internet-based intervention for people with one or more chronic conditions. It is built on self-efficacy theory and is structured around a formal curriculum that emphasizes problem solving, decision making, and confidence building in weekly sessions over six weeks. The curriculum addresses generic topics and skills that are relevant to managing any chronic condition.

The program is structured around three components: 1) password-protected, interactive web-based instruction; 2) web-based bulletin board discussion groups to enable participatory learning and interaction; 3) and a reference book, Living a Healthy Life with Chronic Conditions, that contains the program content and supplemental information. It is facilitated by two trained lay moderators, at least one of whom has a chronic condition.

Piloting the online CDSMP allows Group Health to learn about and maximize the program's impact in the Group Health system before launching a full-scale program. Since web-based interventions are increasingly recognized as holding promise in health care, our learnings and recommendations will likely be applicable beyond this innovation. The pilot provides GH the opportunity to explore the following about the online CDSMP and web-based tools, in general:

1. Impact of the online CDSMP on participants' psychosocial and health status, health behaviors, and health service utilization
2. Efficient processes for incorporating the online CDSMP into existing operations through use of PDCA cycles
3. An understanding of demographic characteristics of members who are more likely to participate in an online self-management program than an in-person program
4. Effective recruitment and retention strategies
5. Feasibility of sustaining the program without external funding
6. Recommendations for successful implementation of future innovations that utilize web-based media, social networking technology, etc.