Effects of self-management programs on behavioral modification among individuals with chronic disease: A systematic review and meta-analysis of randomized trials
Open Access
- 23 July 2021
- journal article
- review article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 16 (7), e0254995
- https://doi.org/10.1371/journal.pone.0254995
Abstract
The prevalence of chronic disease associated with unhealthy lifestyles has been increasing worldwide. Health professionals have recognized that self-management programs (SMPs) can provide health benefits by promoting health behaviors, especially when applied to individuals with lifestyle-related chronic disease. This review performed a meta-analysis of the features of SMPs using randomized studies and analyzed the magnitude of the combined effects of self-management on behavioral modification. We searched the PubMed, CINAHL, ScienceDirect, SCOPUS, Web of Science, Embase, Cochrane Library, DBpia, and KISS to identify randomized trials that evaluated the behavioral outcomes of SMPs. Subgroup analyses were performed for program duration, providers, type of comparisons, and program settings. We selected 25 studies (N = 5,681) to perform analyses with random-effects models. The effect sizes of SMPs were small but significant for physical activity (standardized difference in means [SDM] = 0.25), dietary habits (SDM = 0.28), and health responsibility (SDM = 0.18), and not significant for stress management and smoking behaviors. A short-term SMPs (less than 12 weeks) was indicated as being effective in modifying physical activity, dietary habits, and health responsibility, while the program effects on dietary habits were significant only with expert-delivered education and when compared with inactive controls. The findings of this study indicate that SMPs can effectively improve physical activity, dietary habits, and health responsibility in individuals with chronic disease, with a small but significant effect size. Future studies should explore the effects of SMPs on stress management and smoking cessation and assess the long-term maintenance of healthy lifestyles in individuals with lifestyle-related chronic disease.Funding Information
- National Research Foundation of Korea (NRF-2017R1A2B4006775)
This publication has 44 references indexed in Scilit:
- A Meta-Analysis of Health Status, Health Behaviors, and Health Care Utilization Outcomes of the Chronic Disease Self-Management ProgramPreventing Chronic Disease, 2013
- Twelve-month outcomes of an Internet-based diabetes self-management support programPatient Education and Counseling, 2012
- Lifestyle Change and Mobility in Obese Adults with Type 2 DiabetesThe New England Journal of Medicine, 2012
- Enrolment in primary care networks: impact on outcomes and processes of care for patients with diabetesCMAJ : Canadian Medical Association Journal, 2011
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- The behaviour change wheel: A new method for characterising and designing behaviour change interventionsImplementation Science, 2011
- Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocolImplementation Science, 2011
- The effect of specialist care within the first year on subsequent outcomes in 24 232 adults with new-onset diabetes mellitus: population-based cohort studyHeart, 2007
- Do Increases in Patient Activation Result in Improved Self‐Management Behaviors?Health Services Research, 2006
- Measuring inconsistency in meta-analysesBMJ, 2003