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Telemed J E Health. 2013 Jun;19(6):467-73. doi: 10.1089/tmj.2012.0197. Epub 2013 Apr 9.

Increasing access to chronic disease self-management programs in rural and remote communities using telehealth.

Author information

1
Women's College Research Institute, Department of Physical Therapy, University of Toronto, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario M5G 1V7, Canada. susan.jaglal@utoronto.ca

Abstract

OBJECTIVE:

This study examined whether a telehealth chronic disease self-management program (CDSMP) would lead to improvements in self-efficacy, health behaviors, and health status for chronically ill adults living in Northern Ontario, Canada. Two telehealth models were used: (1) single site, groups formed by participants at one telehealth site; and (2) multi-site, participants linked from multiple sites to form one telehealth group, as a strategy to increase access to the intervention for individuals living in rural and remote communities.

SUBJECTS AND METHODS:

Two hundred thirteen participants diagnosed with heart disease, stroke, lung disease, or arthritis attended the CDSMP at a preexisting Ontario Telemedicine Network studio from September 2007 to June 2008. The program includes six weekly, peer-facilitated sessions designed to help participants develop important self-management skills to improve their health and quality of life. Baseline and 4-month follow-up surveys were administered to assess self-efficacy beliefs, health behaviors, and health status information. Results were compared between single- and multi-site delivery models.

RESULTS:

Statistically significant improvements from baseline to 4-month follow-up were found for self-efficacy (6.6±1.8 to 7.0±1.8; p<0.001), exercise behavior, cognitive symptom management, communication with physicians, role function, psychological well-being, energy, health distress, and self-rated health. There were no statistically significant differences in outcomes between single- and multi-site groups.

CONCLUSIONS:

Improvements in self-efficacy, health status, and health behaviors were equally effective in single- and multi-site groups. Access to self-management programs could be greatly increased with telehealth using single- and multi-site groups in rural and remote communities.

PMID:
23570277
PMCID:
PMC3696947
DOI:
10.1089/tmj.2012.0197
[Indexed for MEDLINE]
Free PMC Article

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