Exploring the Perceived Impact of the Chronic Disease Self-Management Program on Self-Management Behaviors among African American Women with Lupus: A Qualitative Study.

• Type of Material: Article
• Authors: Abena A. Twumasi, Emory University; Anna Shao, Emory University; Charmayne Dunlop-Thomas, Emory University; Cristina Drenkard, Emory University; Hannah Cooper, Emory University
• Language: English
• Date: 2020-03
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1002/acr2.11117
• Title of Journal or Parent Work: ACR Open Rheumatology
• Volume: 2
• Issue: 3
• Start Page: 147
• End Page: 157
• Grant/Funding Information: Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD010455.
• Keywords: Lupus; Chronic Disease; Qualitative Study; Self-management; African American women; Behavior
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Health Care Management; Psychology, Behavioral; Health Sciences, Public Health

Abstract

OBJECTIVE: To qualitatively explore the processes through which the Chronic Disease Self-Management Program (CDSMP)-a peer-led, group-based educational intervention for people with chronic conditions-affects self-management behaviors among African American women with systemic lupus erythematosus (SLE). METHODS: Using a longitudinal pre- and postintervention design, we conducted two waves of one-on-one, semistructured interviews with 24 purposefully sampled participants. Wave 1 interviews explored self-management behaviors at baseline; wave 2 interviews focused on changes in these behaviors postintervention. Transcripts were analyzed using thematic analysis methods. RESULTS: Study participants perceived the CDSMP to be a valuable resource that helped them improve fundamental self-management behaviors, including exercise, relaxation, diet, and medication adherence. We found, with few exceptions, that in this sample, women's reported changes in self-management behaviors did not vary by participant age, education, SLE disease severity, or depression status. Our analysis suggests that the CDSMP had the most widespread perceived effects on relaxation and exercise. Strategies that generated improvements in relaxation and exercise included goal setting, action planning, encouragement to pursue low-impact physical activity, and introduction of mindfulness techniques to better manage SLE symptoms. CONCLUSION: Our findings suggest that African American women with SLE perceived the CDSMP as an effective educational self-management intervention. The program can potentially catalyze improvements in self-management behaviors in this population, regardless of demographic or disease characteristics.