News Release

At-Home Or In-Class, Wellness Lessons Aid Chronically Ill

Peer-Reviewed Publication

Center for Advancing Health

A home-based wellness program that combines videotaped instruction in relaxation, exercise, and nutrition is just as effective in helping older adults cope with chronic illnesses as providing the program in a classroom setting, according to new research.

Patients who completed either wellness program reported greater reductions in anxiety, depression, and other medical symptoms and fewer problems sleeping compared to a control group, says a research team led by Bruce Rybarczyk, Ph.D. of Rush University in Chicago.

"Classroom programs require extensive staff time and on-site attendance for participants, which can be difficult for employed participants," Rybarczyk and colleagues write in the winter issue of Behavioral Medicine. By comparison, home-based programs have "several key advantages, including lower costs, greater accessibility, and the potential for dissemination on a much larger scale."

Rybarczyk and his colleagues recruited 178 patients from a Chicago HMO to participate in the study. One group attended eight 2-hour classroom presentations that included meditation and relaxation training, anxiety and depression management skills, and nutrition and exercise counseling. A second group received a videotaped version of each class, plus brief follow-up phone calls to check on their progress. A final group served as a control.

All of the participants completed questionnaires at the beginning and end of the study to measure their anxiety, depression, and other medical symptoms, as well as their exercise and nutritional habits. The group ranged from 50 to 87 years old, 70 percent were African-American, and all suffered from one or more chronic medical conditions, including hypertension, diabetes, and arthritis.

The researchers found that the home and classroom wellness programs produced similar improvements in participants' lives, compared with the controls -- fewer medical symptoms, less difficulty sleeping and a greater decrease in anxiety and depression.

Although patients clearly felt better after completing the wellness courses, they did not seem to make significant changes in their exercise, diet, or other health-promoting activities. Rybarczyk and his colleagues suggest that patients learned to "look at their chronic illnesses differently, rather than acquiring new health behaviors that change the actual course of the disease."

Also noteworthy, the researchers say, is that the wellness programs were shown to be effective in this group of older, mostly African-American women, who are traditionally under-represented in such programs.

Despite moderate education, the researchers add, patients in both the home and classroom programs spent considerable time reading supplemental materials that focused almost exclusively on practical self-help techniques, a quality that "may have contributed to the appeal."

They cautioned, however, that their research did not examine long-tyerm benefits of the programs.

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Behavioral Medicine is a quarterly journal edited and peer-reviewed by an international team of scientists who research the linkages between human behavior and health. For information about the journal, contact Executive Editor C. David Jenkins, Ph.D., at 919-968-0704.

Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, call Richard Hebert, rhebert@cfah.org 202-387-2829.



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