Abstract 11805: A Community-Based Program to Improve Heart Failure Self-Care
The prevalence of heart failure (HF) among elders is 6.6-9.4%. Despite advances in HF treatment, outcomes remain dismal including poor quality of life, increased healthcare utilization and early mortality. Nearly half of HF related admissions are preventable and attributable to poor self-care. HF self-care encompasses adherence to medication, diet and symptom monitoring behaviors and symptom management by the patient when HF symptoms occur. Unfortunately, traditional HF self-care education delivered as part of hospital-based discharge planning and outpatient care is often ineffective. The purpose of this study guided by a Community Participatory Action framework was to pilot a community-based HF self-care intervention.
Methods: Partnering with key leaders of an urban senior center and clinicians providing care to an underserved population with HF; 22 adults with HF were recruited from healthcare and community settings and randomized to the intervention group or to a wait-listed control group. Weekly sessions led by a health educator, focused on building skill in the essential elements of self-care (i.e., how to plan and prepare low salt meals, identify signs of worsening HF; and symptom management). Standardized instruments were used to measure self-care (Self-Care of Heart Failure Index) and knowledge (Dutch Heart Failure Knowledge Survey) at baseline, 1 month and 3 months. Changes in self-care and knowledge were assessed using non-parametric statistics.
Results: The sample was 50% female, 23% Hispanic and 27% African American; (mean age 70 ±9 years). There was a significant improvement in self-care maintenance (p=.028), self-care management (p=.05) and knowledge (p=.02) in the treatment group at 1 month after the intervention compared to the control group, which showed no change. Improvements in self-care management and knowledge were sustained at three months.
Conclusions: This novel approach shows promise in addressing the significant challenges in self-care faced by HF patients. The group format highlights senior center resources and leverages social supports essential to community-dwelling elders. Focus group feedback from participants and partners confirmed the acceptability and feasibility of the community-based program.
- © 2011 by American Heart Association, Inc.