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SELF
CARE MANAGEMENT PROGRAM TO INCREASE PHYSICAL ACTIVITY IN WOMEN This study evaluates the Self Care Management Program (SMP) as an intervention for a population of vulnerable, high-risk, older, overweight women from diverse ethnic backgrounds, and with lower socioeconomic and literacy levels. This population experiences persistent disparities in health status and access to preventive health services. The focus of the program intervention is on examining these women's self-efficacy, their self-care management, and their adoption and/or maintenance of a healthy lifestyle behavior--specifically moderate physical activity. The SMP intervention, derived from a Chronic Disease Self-Care Management Program (Lorig et al, 1996), and tailored as a culturally and ethnically sensitive program without the chronic disease component, uses trained lay leaders from the population of women served. It combines a cognitive approach directed at women learning strategies and methods to become better self-care managers, an affective approach directed at building their self-efficacy, and individualized attention and practice, as well as supportive reinforcement for adopting and maintaining healthy lifestyle behaviors. The target population is women who are currently clients at a local university-sponsored community women's wellness center. Women who typically attend this center are ethnically diverse, economically disadvantaged, have low literacy and education levels, lack access to regular and preventive health care, are generally overweight, and have poor knowledge about healthful behaviors. A pilot study with women (n=5) from this population was completed to tailor the SMP to make it more culturally and ethnically relevant for this population, to refine the program in collaboration with the participants, and to refine the study questionnaire. Thirty subjects are being recruited from the center and from referrals by community partners, and will be assigned to one of two groups, an experimental and a control group. The experimental group will attend the SMP first conducted by two trained lay leaders. The control group will be placed on the waiting list for the second offering of the SMP. The SMP will consist of presentations, discussions, interactions, and performance of activities and practice exercises about a variety of topics focused on self-care and moderate physical activity. All subjects will complete the questionnaire at the beginning of the first SMP offering and again four months later. Differences in groups will be examined using valid and reliable measures of self-efficacy, self-care management behaviors, and physical activity behaviors. This study represents the first step in engaging this population of women in healthful behaviors. If the tailored intervention is successful, it can be generalized to other healthful behaviors and could form the basis for establishing a research-based clinical practice at the wellness center. STATUS: Ongoing through 5/2002, Data Collection in Progress, Spring, 2002. You may soon read articles about this study in the following publications. Grobe, S. J., & Craig, K. K. (in review). Self-care management program to increase physical activity for low income, ethnically diverse older women: Report of a pilot study. Family and Community Health. Craig, K. K., & Grobe, S. J. (in review). Theoretical development of a public health nursing model for health promotion for low-income women. Advances in Nursing Science.
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