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Published Online: 1 July 2011

Disparities by Education Level in Outcomes of a Self-Management Intervention: The DELTA Trial in the Netherlands

Hans Bosma, Ph.D., Femke Lamers, Ph.D., Catharina C. M. Jonkers, Ph.D., and Jacques T. van Eijk, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 62, Number 7
https://doi.org/10.1176/ps.62.7.pss6207_0793
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Abstract

Objective:

The study examined whether education level was associated with benefits derived from a self-management intervention. Because such interventions increase one's sense of control, it was hypothesized that persons with less education, who generally have a diminished sense of control, would derive greater benefit.

Methods:

A randomized trial was conducted with 361 patients aged 60 and older with type 2 diabetes or chronic obstructive pulmonary disease and mild to moderate depression. The intervention provided individualized contacts (two to ten) with nurses who taught participants to take control of their disease.

Results:

Positive effects on depression, health-related quality of life, feelings of mastery, and self-efficacy were confined to patients with more education; those with only a primary education did not benefit.

Conclusions:

Only more highly educated patients profited from a cognitive-behavioral approach to self-management. Patients with chronic conditions who have less education may derive greater benefits if environmental adversities or lower cognitive abilities are taken into account. (Psychiatric Services 62:793–795, 2011)

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Figure 1 Scores at nine months on the Beck Depression Inventory of 361 patients, by treatment condition and level of education

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 62 • Number 7 • July 2011
Pages: 793 - 795
PubMed: 21724794

History

Published online: 1 July 2011
Published in print: July 2011

Authors

Details

Hans Bosma, Ph.D.
The authors are affiliated with the School for Public Health and Primary Care (CAPHRI), Department of Social Medicine, Maastricht University, P.O. Box 616, Maastricht 6200 MD, Netherlands (e-mail: [email protected]).
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Femke Lamers, Ph.D.
The authors are affiliated with the School for Public Health and Primary Care (CAPHRI), Department of Social Medicine, Maastricht University, P.O. Box 616, Maastricht 6200 MD, Netherlands (e-mail: [email protected]).
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Catharina C. M. Jonkers, Ph.D.
The authors are affiliated with the School for Public Health and Primary Care (CAPHRI), Department of Social Medicine, Maastricht University, P.O. Box 616, Maastricht 6200 MD, Netherlands (e-mail: [email protected]).
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Jacques T. van Eijk, Ph.D.
The authors are affiliated with the School for Public Health and Primary Care (CAPHRI), Department of Social Medicine, Maastricht University, P.O. Box 616, Maastricht 6200 MD, Netherlands (e-mail: [email protected]).
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Notes

These findings were presented at the International Congress for Behavioral Medicine, held August 27–30, 2008, in Tokyo.

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