Factors Associated With Participation in the Chronic Disease Self-Management Program: Findings From the SUCCEED Trial

Autor: Ali Razmara, Theresa Sivers-Teixeira, Marissa Castro, Martin Lee, Amytis Towfighi, Jamie L. Tran, Patricia Gomez, Phyllis Willis, Betty Shaby, Amy M. Lin, Bijal Mehta, Elizabeth Mojarro-Huang, Ana Montoya, Renee Johnson, Frances Barry, Eric M. Cheng, Marilyn Corrales, Nerses Sanossian, Barbara G. Vickrey, Tara Dutta, Chris Ediss, Shlee S. Song, Monica Ayala-Rivera, Robert Bryg
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
self-management
Aging
Clinical Trials and Supportive Activities
Clinical Sciences
Cardiorespiratory Medicine and Haematology
Article
law.invention
Quality of life (healthcare)
Randomized controlled trial
law
Clinical Research
Behavioral and Social Science
Secondary Prevention
Medicine
Humans
Self management program
Stroke survivor
Aged
Advanced and Specialized Nursing
Self-efficacy
Secondary prevention
Self-management
Neurology & Neurosurgery
business.industry
Ischemic Attack
Transient
Self-Management
Prevention
Rehabilitation
Neurosciences
Middle Aged
Self Efficacy
Brain Disorders
Stroke
Chronic disease
Good Health and Well Being
quality of life
Ischemic Attack
Transient
Chronic Disease
Physical therapy
Quality of Life
Female
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
self-efficacy
Zdroj: Stroke, vol 51, iss 10
Stroke
Popis: Background and Purpose: Self-management programs may improve quality of life and self-efficacy for stroke survivors, but participation is low. In a randomized controlled trial of a complex, multidisciplinary, team-based secondary stroke prevention intervention, we offered participants Chronic Disease Self-Management Program (CDSMP) workshops in addition to clinic visits and home visits. To enhance participation, workshops were facilitated by community health workers who were culturally and linguistically concordant with most participants and scheduled CDSMP sessions at convenient venues and times. Over time, we implemented additional strategies such as free transportation and financial incentives. In this study, we aimed to determine factors associated with CDSMP participation and attendance. Methods: From 2014 to 2018, 18 CDSMP workshop series were offered to 241 English and Spanish-speaking individuals (age ≥40 years) with recent stroke or transient ischemic attack. Zero-inflated Poisson regression was used to identify factors associated with participation and attendance (ie, number of sessions attended) in CDSMP. Missing values were imputed using multiple imputation methods. Results: Nearly one-third (29%) of intervention subjects participated in CDSMP. Moderate disability and more clinic/home visits were associated with participation. Participants with higher numbers of clinic and home visits (incidence rate ratio [IRR], 1.06 [95% CI, 1.01–1.12]), severe (IRR, 2.34 [95% CI, 1.65–3.31]), and moderately severe disability (IRR, 1.55 [95% CI, 1.07–2.23]), and who enrolled later in the study (IRR, 1.12 [95% CI, 1.08–1.16]) attended more sessions. Individuals with higher chaos scores attended fewer sessions (IRR, 0.97 [95% CI, 0.95–0.99]). Conclusions: Less than one-third of subjects enrolled in the SUCCEED (Secondary Stroke Prevention by Uniting Community and Chronic Care Model Teams Early to End Disparities) intervention participated in CDSMP; however, participation improved as transportation and financial barriers were addressed. Strategies to address social determinants of health contributing to chaos and engage individuals in healthcare may facilitate attendance. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01763203.
Databáze: OpenAIRE
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