Table 3. Overall Effect Sizea at 4 to 6 Months, by Delivery Mode, Meta-Analysis of the Chronic Disease Self-Management Program, Studies Published 1999–2009.
Outcome | English-Speaking Small Group (n = 15) | Spanish-Speaking Small Group (n = 2) | Small Group Translation (n = 1) | Internet Delivery (n = 2) | Individual In-home (n = 2) | Between-Groups P Valueb |
---|---|---|---|---|---|---|
Health behavior | ||||||
Aerobic exercise | 0.12c | 0.33c | — | 0.09 | — | .05 |
Cognitive symptom management | 0.26c | — | 0.39c | 0.16 | — | .54 |
Communication with physician | 0.25c | 0.16 | — | 0.22 | — | .84 |
Stretching/strengthening exercise | 0.12 | — | — | 0.17 | — | .63 |
Psychological health status | ||||||
Depressiond | −0.22c | — | −0.08 | — | <.001 | .06 |
Health distressd | −0.28c | −0.55c | −0.20 | −0.26c | — | .17 |
Overall self-efficacy | 0.34c | 0.37c | 0.39 | 0.24 | 0.14 | .82 |
Self-efficacy for chronic disease management | 0.26c | — | — | — | — | — |
Self-efficacy for management of other symptoms | 0.28c | — | — | — | — | — |
Physical health status | ||||||
Energy | 0.16c | — | 0.39c | — | — | .23 |
Fatigued | −0.15c | −0.12 | −0.24c | −0.14c | — | .85 |
Functional disabilityd | −0.05 | — | −0.08 | −0.02 | −0.001 | .92 |
Paind | −0.16c | −0.28c | — | −0.11c | — | .04 |
Self-rated health | 0.14c | 0.31c | 0.39c | 0.01 | — | .16 |
Social role limitationsd | −0.17c | −0.30c | −0.18 | — | — | .06 |
Shortness of breathd | −0.13c | −0.20 | −0.04 | −0.12 | — | .84 |
Health care utilization | ||||||
Emergency department visitsd | −0.02 | −0.10 | −0.04 | −0.06 | — | .81 |
Physician visitsd | −0.05 | 0.02 | −0.12 | −0.07 | — | .87 |
Hospitalization days or nightsd | −0.08c | −0.02 | — | 0.05 | — | .17 |
Hospitalization timesd | −0.01 | — | — | −0.003 | — | .92 |
Abbreviation: —, data not reported.
Effect size is the combination of the standardized differences in means for all eligible studies.
Determined by Q test for between-groups heterogeneity.
P < .01, determined by z score test for significance of pooled effect size.
Negative effect size indicates positive effect (eg, a decrease in depression).