Author, year | Country | Intervention characteristics | Participants, n | Study characteristics | ||||
Intervention | Target population and sample size | Study design | Evaluation design | Results | Quality assessment | |||
Altun, 200821 | Turkey | Health promotion course on the enhancement of self-care agency and health-promoting behaviours through 30 hours of classroom lectures via lectures, group discussions and instructional videos. | University students | 41 students | Cohort study | Single group; pre-post evaluation within a 15-week semester | Self-care agency scores and health promotion behaviours all showed significant increase after intervention. | Weak |
Ball and Bax, 200227 | USA | Educational intervention with a self-care component in a classroom format to promote healthy behaviours and positive emotional adjustment during the semester. The self-care intervention was supplemented by self-awareness feedback sessions for some participants. | Medical students | 32 men and 22 women | Cohort study | Pre-post evaluation design | Those in the self-care intervention had a higher likelihood of having consistent sleeping times, increased exercise frequency and less trouble falling asleep, but alcohol consumption was not affected. | Weak |
Benson et al, 198928 | USA | ‘Staying Healthy After Fifty’; a nationwide educational programme for the elderly based on a previous programme comprising 11 sessions. | General elderly population | 161 intervention participants 164 control group participants | Quasiexperimental trial | Intervention and control group; pre-post evaluation with a 6-month follow-up | The intervention group scored higher in health skills, health actions and health costs scale. The improvement continued over time. | Weak |
Caserta et al, 200130 | USA | ‘Pathfinders’ is a formal self-care and health education programme for older widows and widowers covering a range of health-promotive topics in 11 weeks. Delivered by experts in a classroom format using lectures, group discussion, goal setting exercises and distributing written information. A grief counsellor was also present. | Older widows and widowers | 84 widows and widowers | Cohort study | Single group; pre-post evaluation with 2 and 4 months’ follow-up | The attendance rate for the programme was 71% and participants scored high on behavioural intention and behavioural attitude. Learning to take care of themselves was the most important benefit for the study participants. | Weak |
Hartweg and Metcalfe, 198631 | USA | Self-care curriculum based on Orem's self-care deficient theory which was incorporated to the university courses throughout the nursing degree programme. | Nursing students | 40 nursing students and 71 non-nursing students | Cohort study | Pre-post design; beginning of the programme and follow-up after 3 years once the course was over. | Nursing students had a significantly stronger attitude towards self-care than non-nursing students. Area of residence is a confounding factor. | Moderate |
Kemper, 198223 | USA | An informal self-care educational programme of 10 sessions targeting symptom monitoring, lifestyle changes and confidence building. It was led by a nurse practitioner and reading material was provided. | General population | Experimental group:107 families Control group: 110 families | Randomised controlled trial | Pre-post design with 6 and 12 months’ follow-up | Self-care knowledge increased by 125% in the intervention group and only 8% in the control group. The increment was consistent during both follow-up periods. The intervention was also shown to be cost-effective in that the intervention group accrued less medical costs than the control group. | Moderate |
May and Evans, 199434 | USA | Health education programme with a health promotion and prevention focus for known health problems of the homeless. It was conducted in a classroom format using lectures and presentations by community health nurses. | Homeless population | 2404 homeless clients from 13 urban shelters and treatment sites | Cross-sectional study | Repeated questionnaires given to the participants over the intervention period of 18 months. | 98% of the participants found the presentations to be useful. Positive programme evaluation was assumed to have positive outcomes. | Weak |
Nelson et al, 198429 | USA | A self-care education programme with 13 classes with reinforcement activities that continued for a year where clinical medicine, lifestyle and independent living were all addressed. It was delivered by a trained team through group discussions, skill training, role-playing and self-contracting. | Elderly population | 341 individuals from New Hampshire | Quasiexperimental trial | Interviews were conducted by trained interviewers and a skills performance was conducted after intervention and at 1-year follow-up. | Intervention group showed more confidence in self-care tasks and the gains did not decrease over time. The lifestyle changes attempted were higher for the intervention group but these increments did not sustain over time. | Weak |
Porter et al, 199220 | Egypt | ‘Parental Enhancement Program,’ an educational supportive programme which included systematically planned classes delivered face to face using discussions and role-play. | Egyptian mothers | 58 mothers | Quasiexperimental trial | Pre-post evaluation design with 3 months, 6 and 12 months’ follow-up. | Self-care agency, self-esteem and maternal perception showed no changes in the intervention group. The control group showed positive self-care agency and self-esteem scores. | Weak |
Roberts et al, 198919 | Islands of Hawaii, Oahu and Maui | ‘Staying Healthy After Fifty,’ a nationwide educational programme for the elderly of 11 sessions culturally adapted to suit the Hawaii Asian-American population. | Elderly population | 89 questionnaires from the course group 166 questionnaires from the comparison group | Quasiexperimental trial | Pre-post evaluation design with 3 and 6 months’ follow-up | Course participants scored higher in health skills, health actions, healthcare costs and use of medical reference book. The improvements continued over time as well. | Weak |
Seideman, 199024 | USA | ‘Premenstrual Syndrome Educational Program’ done in a classroom setting using presentations. Information sessions on PMS, lifestyle discussions and booklets were used to disseminate information. | Women experiencing moderate to severe PMS symptoms | 47 women | Cohort study | PMS symptoms were recorded over 3 months and participants were contacted at 2-week intervals for reinforcement. | The intervention group reported significantly lower occurrences of PMS symptoms, lower severity of the symptoms and lesser number of days with premenstrual symptoms. | Moderate |
Stark et al, 200532 | USA | ‘Nurse's Role in Facilitating Health and Self-Care,’ a semester-long educational university self-care course that included a lifestyle self-care plan and a self-care assessment delivered in a classroom format. | Nursing students | 67 nursing students | Cohort study | Single group; pre-post evaluation with a mid-semester and end-of-semester evaluation | Participants significantly changed their lifestyle behaviours and older students had more health-promoting behaviours and health responsibility. | Weak |
Timmerman, 199933 | USA | Health promotion course focused on developing a lifestyle self-care plan (LSCP) delivered in a classroom format, covering health promotion topics of nutrition, exercise and stress management. | Nursing students | 95 students | Cohort study | Mid-post evaluation with a 6-month follow-up | Immediately after the intervention only 42.1% had achieved their goal. At the 6 months’ follow-up 52% of the participants had achieved their lifestyle goals. | Weak |
Vickery et al, 198825 | USA | The self-care intervention was a mixed intervention with three options of written materials, telephone information service and an individual counselling session. Group 1: written materials, telephone service and individual counselling. Group 2: written materials and telephone service. Group 3: written materials only. Group 4: no intervention | General population | 1625 households | Randomised controlled trial | Pre-post evaluation design with 12 months’ follow-up | All experimental groups showed a significant decrease in ambulatory care utilisation in comparison to the control group. The intervention was found to be cost-effective in comparison to usual or no care. The telephone information service was not used as anticipated (<20 calls per year). | Moderate |
Vickery et al, 198326 | USA | ‘Cooperative Health Education Programme’ aimed to assess medical care utilisation using a written material and a telephone information service. | General population | 1249 individuals | Randomised controlled trial | Pre-post design with 6 and 12 months’ follow-up | Significant reductions in total ambulatory visits and a decrease in all medical care provider utilisations by the intervention group. The telephone information service was not used as anticipated. Written material was used the most. | Weak |
White et al, 201222 | UK | A policy-driven community self-care intervention exploring the attitudes and skills related to self-care and healthcare delivered by Self Care Support Coordinators in Primary Care Trusts in small group sessions. | General population | 1568 participants were included in the study. | Quasiexperimental trial—cohort study | Prequestionnaire with 6 and 12 months’ follow-up. Participant health data were analysed 1 year before the study as well. | No detectable differences in the number of GP consultations or perceived health status. Small positive effects on psychological outcomes that include self-esteem, anxiety and subjective well-being. | Weak |
GP, general practitioner; PMS, premenstrual syndrome.