Women take PRIDE

Limited information is available related to the unique problems that women, especially older women, face in managing their heart disease and adhering to their physicians' recommendations.  Developing interventions for women with heart disease is critical to providing effective health care for at least two reasons: first, to alleviate the burden of this significant and increasingly prevalent chronic disease on women; and second, to alleviate the burden that their disability has on society.  An innovative disease management program ("take PRIDE") for older adults with heart disease evolved into "Women take PRIDE.", a program based on principles of self-regulation and tailored to the unique needs of older women with a range of heart conditions. 

The current randomized controlled trial enrolled 1128 women age 60 years and older with diagnosed heart disease to evaluate two formats for providing disease management education over 18 months.  One format offers the "Women take Pride" self-management program in a group setting which meets weekly for six weeks.  In the alternative self-directed version, the women attend an orientation session and then complete the six-week program at home and on their own time with telephone support from a nurse/health educator.

The study is also examining the effect of choice of learning format on the self-management behavior and functioning of participants through a two-arm design.  One arm employs a randomized control design to examine the effectiveness of the group and self-directed formats of the "Women take PRIDE" program compared to a "usual care" control group.  Initial analysis showed that the formats produced different outcomes.  At 18 months the self-directed format resulted in significant improvements in cardiac symptoms compared to the controls and reduced frequency of all types of symptoms compared to the group format.  Participants in the group format reported improved ambulation at 12 months compared to the controls and weight loss at 18 months compared to the self-directed format participants.

Concurrently, a second arm is examining the effect of choice of format on the women's functioning by inviting the participants to choose to receive either the "Women take PRIDE" group-format education or the self-guided version. Data analysis and report preparation continues.  

Project-related Presentations:

Dodge, J.A., Janz, N.K. Janevic, M.R., Clark, N.M.  "Participant Preference as a Dimension in the Evolution of a Heart Disease Management Program for Older Women", presented at the 129th Annual Meeting of the American Public Health Association, Atlanta, GA, October 21-25, 2001.

Dodge, J.A., Janz, N.K., Janevic, M.R., Clark, N.M.  "Incorporating Participant Preference into the Evaluation of a Heart Disease Management Program", presented at the Interdisciplinary Conference of the American Psychological Association, Washington, D.C., February 20-23, 2002.

Dodge, J.A., Janz, N.K., Clark, N.M. "Reducing Stress In Older Women With Heart Disease: The Effect Of A Self-Management Program", presented at the 130th Annual Meeting of the American Public Health Association in Philadelphia, PA, November 9-13, 2002.

Dodge, J.A., Janz, N.K., Clark, N.M. "Evaluation of the 'Women take PRIDE' Heart Disease Management Program: Does Program Format Matter?" presented at the 132nd Annual Meeting of the American Public Health Association in Washington, DC, November 6-10, 2004.

Project-related Publications:

Janevic, M.R., Janz, N.K., Dodge, J.A., Wang, Y., Lin, X. Clark, N.M. Longitudinal effects of social support on the health and functioning of older women with heart disease. The International Journal of Aging & Human Development, 59(2): 13-175, 2004.  

Janz, N.K., Dodge, J.A., Janevic, M.R., Lin, X., Donaldson, A.E., Clark, N.M. Understanding and reducing stress and psychological distress in older women with heart disease.  Journal of Women & Aging, 16(3/4): 19-38, 2004 

Clark, N.M., Janz, N.K., Dodge, J.A., Lin, X., Trabert, B.L., Kaciroti, N., Mosca, L., Wheeler, J.R.C., Keteyian, S. Heart disease management by women: does intervention format matter?  Health Education and Behavior (Accepted for publication 2008)

Clark, N.M., Janz, N., Dodge, J.A., Little, R. The effect of patient choice of intervention on health outcomes. Contemporary Clinical Trials. (under review 2008).  

For more information on this project, please contact Julie Dodge at jadodge@umich.edu