OBJECTIVE: Most of the day-to-day care for heart failure (HF) is done by the patient at home and requires skill in self-care. In this randomized controlled trial (RCT) we tested the efficacy of a community-based skill-building intervention on HF self-care, knowledge and health-related quality of life (HRQL) at 1- and 3-months. METHODS: An ethnically diverse sample (n = 75) of patients with HF (53% female; 32% Hispanic, 27% black; mean age 69.9 +/- 10 years) was randomized to the intervention group (IG) or a wait-list control group (CG). The protocol intervention focused on tactical and situational HF self-care skill development delivered by lay health educators in community senior centers. Data were analyzed using mixed (between-within subjects) ANOVA. RESULTS: There was a significant improvement in self-care maintenance (F[2,47] = 3.42, p = 0.04, (Cohen's f = 0.38)), self-care management (F[2,41] = 4.10, p = 0.02, (Cohen's f = 0.45) and HF knowledge (F[2,53] = 8.00, p = 0.001 (Cohen's f = 0.54)) in the IG compared to the CG. CONCLUSIONS: The skill-building intervention improved self-care and knowledge but not HRQL in this community-dwelling sample. PRACTICE IMPLICATIONS: Delivering an intervention in a community setting using lay health educators provides an alternative to clinic- or home-based teaching that may be useful across diverse populations and geographically varied settings.
With permission from Excerpta Medica Inc.

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