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Hispanic Chronic Disease Self-Management: A Randomized Community-Based Outcome Trial

Lorig, Kate R.; Ritter, Philip L.; González, Virginia M.


Background In light of health disparities and the growing prevalence of chronic disease, there is a need for community-based interventions that improve health behaviors and health status. These interventions should be based on existing theory.

Objective This study aimed to evaluate the health and utilization outcomes of a 6-week community-based program for Spanish speakers with heart disease, lung disease, or type 2 diabetes.

Method The treatment participants in this study (n = 327) took a 6-week peer-led program. At 4 months, they were compared with randomized wait-list control subjects (n = 224) using analyses of covariance. The outcomes for all the treatment participants were assessed at 1 year, as compared with baseline scores (n = 271) using t-tests.

Results At 4 months, the participants, as compared with usual-care control subjects, demonstrated improved health status, health behavior, and self-efficacy, as well as fewer emergency room visits (p < .05). At 1 year, the improvements were maintained and remained significantly different from baseline condition.

Conclusions This community-based program has the potential to improve the lives of Hispanics with chronic illness while reducing emergency room use.

Kate R. Lorig, DrPH, is Professor (Research).

Philip L. Ritter, PhD, is Programmer Analyst.

Virginia M. González, MPH, is former Research Associate, Department of Medicine, Stanford University School of Medicine, Stanford, California.

The authors thank Maria Marin, formerly of the Stanford University School of Medicine, and Mirna Sanchez, Stanford University School of Medicine, for their invaluable assistance at many stages of this study; and our many volunteer group leaders.

This program was supported by NINR grant 5R01NOR4438 and by University of California Berkeley Tobacco Related Disease Research Program grant 6LT0107. The Web site for the Stanford Patient Education Research Center is http://patienteducation. The instruments used in this study are available there.

Corresponding author: Kate R. Lorig, DrPH, 1000 Welch Road, Suite 204, Palo Alto, CA 94304 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.