PURPOSE: To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. DESIGN: Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. SETTING: Community. PARTICIPANTS: N = 10 792. MEASURES: Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. ANALYSIS: Meta-analysis using pooled effect sizes. RESULTS: Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. CONCLUSION: Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.
PURPOSE: To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. DESIGN: Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. SETTING: Community. PARTICIPANTS: N = 10 792. MEASURES: Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. ANALYSIS: Meta-analysis using pooled effect sizes. RESULTS: Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. CONCLUSION: Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.
Entities:
Keywords:
chronic diseases; community program; implementation factors; program outcomes; self-management
Authors: Louise Schinckus; Stephan Van den Broucke; Gerard van der Zanden; Diane Levin-Zamir; Gabriele Mueller; Henna Riemenschneider; Victoria Hayter; Lucy Yardley; Dean Schillinger; Gerardine Doyle; Kristin Ganahl; Jürgen Pelikan; Peter Chang Journal: Int J Environ Res Public Health Date: 2021-04-13 Impact factor: 3.390