{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:16:55Z","timestamp":1780327015123,"version":"3.54.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000975","name":"Kidney Health Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) imposes physical, psychological, and social burdens. While self-management is essential in CKD, many existing interventions lack theoretical grounding and patient co-design. The Kidney Health 4 Life (KH4L) program was developed to address these gaps via a modular, online, peer-supported self-management intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This open-label, single-blind, parallel group randomized controlled trial recruited Australian adults with CKD. Participants were randomized 1:1 to receive the KH4L intervention or standard care. The intervention consisted of six self-paced online modules, health coaching, and peer support. The primary outcome was self-management capability. Secondary outcomes included self-efficacy, knowledge, and psychological wellbeing. Outcomes were assessed at baseline, 6 weeks, and 18 weeks post baseline. Linear mixed models were utilized for quantitative outcomes and qualitative feedback was analysed using simple thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 394 enrolled, 383 were included in the analysis. There was no significant change in the primary outcome of total self-management scores. However, the\u00a0intervention group showed significant improvements in problem solving (P\u00a0=\u00a0.009), self-efficacy (P\u00a0=\u00a0.048), and CKD-related knowledge (P\u00a0=\u00a0.017). Mixed results were seen with the psychological outcomes with depression scores improving more in the control group (P\u00a0=\u00a0.043) and no improvement in anxiety. Subgroup analyses indicated greater benefits for those accessing CKD-specific modules compared to dialysis-specific content, possibly due to smaller sample size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>KH4L improved some self-management outcomes in people with CKD. The findings highlight the value of tailored, stage-specific digital interventions and suggest theory-informed programs can improve self-efficacy and knowledge. Further research is needed to optimize engagement and ascertain long-term impacts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag154","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:30:07Z","timestamp":1778585407000},"source":"Crossref","is-referenced-by-count":0,"title":["Randomized clinical trial of the KH4L self-management program"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-7328","authenticated-orcid":false,"given":"Kelly","family":"Lambert","sequence":"first","affiliation":[{"name":"School of Medical Indigenous and Health Sciences, University of Wollongong , New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Kidney Health Australia , Southbank, Victoria 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