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Self-Management of Heart Disease by Older Adults

Assessment of an Intervention Based on Social Cognitive Theory

University of Michigan School of Public Health

Nancy K. Janz

University of Michigan School of Public Health

Julia A. Dodge

University of Michigan School of Public Health

M. Anthony Schork

University of Michigan School of Public Health

John R. C. Wheeler

University of Michigan School of Public Health

Jersey Liang

University of Michigan School of Public Health

Steven J. Keteylan

Henry Ford Heart and Vascular Institute, Henry Ford Hospital

John T. Santinga

University of Michigan Hospitals

A randomized, controlled trial involving 636 older individuals was conducted to evaluate an intervention to enhance self-management of heart disease. Program participants experienced less impact of illness on their psychosocial functioning (p <.05), especially their emotional behavior (p <.05) and alertness (p < .01). Compared to controls, male program participants experienced improvements in their physical functioning, specifically their ability to ambulate (p <.05) and the frequency and severity of their symptoms. Female program participants did not experience gains in physical functioning. Most group differences emerged by 12 months and decayed by the 18-month final evaluation. To accurately assess the pattern of change associated with a program of this type, evaluation over at least 18 months following program completion may be needed. Separate interventions for older men and women with heart disease appear warranted, as do follow-up activities at strategic points in time to sustain program effects.

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