Perceived control moderated the self-efficacy-enhancing effects of a chronic illness self-management intervention

Anthony F Jerant, Monique Moore, Kate Lorig, Peter Franks

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Objective: Identifying moderators of the effects of self-efficacy-enhancing interventions could improve their efficiency. We examined the effects of a home-based variant of the Chronic Disease Self-Management Program on self-efficacy, and explored the moderating effects of perceived control over self-management (PCSM). Methods: In a randomized controlled trial, patients (N= 415) aged>40 years with various chronic conditions plus basic activity impairment and/or significant depressive symptoms were randomized to one of three groups: intervention provided in homes or by telephone, v. usual care control. We used mixed effects linear models for repeated measures to examine effects on self-management self-efficacy at 6-month follow-up and explore moderation by PCSM. Results: Only the home intervention had a significant self-efficacy-enhancing effect (Wald test, χ2 = 13.8, p = 0.008; effect size = 0.3). The effect was moderated by PCSM, considered as a continuous [effective in subjects with lower PCSM (Wald test, χ2 = 13.4, p = 0.009)] or categorical (effective only for subjects in the lowest tercile) variable. Conclusions: People with lower PCSM appear more likely to experience enhanced self-efficacy from chronic illness self-management training than those with higher PCSM. These findings, although preliminary, suggest that office-based measurement of PCSM might identify those chronically ill patients likely to benefit most from self-management training.

Original languageEnglish (US)
Pages (from-to)173-182
Number of pages10
JournalChronic Illness
Volume4
Issue number3
DOIs
StatePublished - Sep 2008

Keywords

  • Chronic disease
  • Perceived control
  • Self-care
  • Self-efficacy
  • Telephone

ASJC Scopus subject areas

  • Medicine(all)
  • Health Policy

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