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

被引:10
作者
Lin, Amy M. [1 ,3 ]
Vickrey, Barbara G. [4 ]
Barry, Frances [5 ]
Lee, Martin L. [5 ]
Ayala-Rivera, Monica [1 ,2 ,7 ]
Cheng, Eric
Montoya, Ana V. [8 ]
Mojarro-Huang, Elizabeth [2 ]
Gomez, Patricia [7 ]
Castro, Marissa [2 ,7 ]
Corrales, Marilyn [7 ]
Sivers-Teixeira, Theresa [1 ,7 ]
Tran, Jamie L. [8 ]
Johnson, Renee [7 ]
Ediss, Chris [7 ]
Shaby, Betty [9 ,10 ]
Willis, Phyllis [11 ]
Sanossian, Nerses [1 ,2 ]
Mehta, Bijal [5 ,8 ]
Dutta, Tara [7 ,12 ]
Razmara, Ali [7 ,13 ]
Bryg, Robert [6 ,10 ]
Song, Shlee [14 ]
Towfighi, Amytis [1 ,2 ,7 ]
机构
[1] Univ Southern Calif, Dept Neurol, Los Angeles, CA 90007 USA
[2] LAC USC Med Ctr, Dept Neurol, Los Angeles, CA USA
[3] Washington Univ, Dept Neurol, St Louis, MO 63110 USA
[4] Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY 10029 USA
[5] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA USA
[6] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA
[7] Rancho Los Amigos Natl Rehabil Ctr, Dept Neurol, Downey, CA USA
[8] Harbor UCLA Med Ctr, Dept Neurol, Torrance, CA 90509 USA
[9] Olive View UCLA Med Ctr, Dept Neurol, 14445 Olive View Dr, Sylmar, CA 91342 USA
[10] Olive View UCLA Med Ctr, Dept Med, 14445 Olive View Dr, Sylmar, CA 91342 USA
[11] Watts Labor Community Act Comm, Los Angeles, CA USA
[12] Univ Maryland, Dept Neurol, Baltimore, MD 21201 USA
[13] Kaiser Permanente, Dept Neurol, Irvine, CA USA
[14] Cedars Sinai Med Ctr, Dept Neurol, Los Angeles, CA 90048 USA
关键词
quality of life; secondary prevention; self-efficacy; self-management; HEALTH-STATUS; STROKE; CARE; BARRIERS; SUPPORT;
D O I
10.1161/STROKEAHA.119.028022
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
引用
收藏
页码:2910 / 2917
页数:8
相关论文
共 21 条
  • [1] Do cognitive, language, or physical impairments affect participation in a trial of self-management programs for stroke?
    Cadilhac, Dominique A.
    Kilkenny, Monique F.
    Srikanth, Velandai
    Lindley, Richard I.
    Lalor, Erin
    Osborne, Richard H.
    Batterbsy, Malcolm
    [J]. INTERNATIONAL JOURNAL OF STROKE, 2016, 11 (01) : 77 - 84
  • [2] A Phase II Multicentered, Single-Blind, Randomized, Controlled Trial of the Stroke Self-Management Program
    Cadilhac, Dominique A.
    Hoffmann, Sally
    Kilkenny, Monique
    Lindley, Richard
    Lalor, Erin
    Osborne, Richard H.
    Batterbsy, Malcolm
    [J]. STROKE, 2011, 42 (06) : 1673 - 1679
  • [3] Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors A Randomized Controlled Trial
    Cheng, Eric M.
    Cunningham, William E.
    Towfighi, Amytis
    Sanossian, Nerses
    Bryg, Robert J.
    Anderson, Thomas L.
    Barry, Frances
    Douglas, Susan M.
    Hudson, Lillie
    Ayala-Rivera, Monica
    Guterman, Jeffrey J.
    Gross-Schulman, Sandra
    Beanes, Sylvia
    Jones, Andrea S.
    Liu, Honghu
    Vickrey, Barbara G.
    [J]. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2018, 11 (01):
  • [4] One size does not fit all - Stroke survivor's views on group self-management interventions
    Clark, Ella
    Bennett, Kate
    Ward, Nick
    Jones, Fiona
    [J]. DISABILITY AND REHABILITATION, 2018, 40 (05) : 569 - 576
  • [5] Racial-Ethnic Disparities in Stroke Care: The American Experience A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
    Cruz-Flores, Salvador
    Rabinstein, Alejandro
    Biller, Jose
    Elkind, Mitchell S. V.
    Griffith, Patrick
    Gorelick, Philip B.
    Howard, George
    Leira, Enrique C.
    Morgenstern, Lewis B.
    Ovbiagele, Bruce
    Peterson, Eric
    Rosamond, Wayne
    Trimble, Brian
    Valderrama, Amy L.
    [J]. STROKE, 2011, 42 (07) : 2091 - 2116
  • [6] The impact of competing subsistence needs and barriers on access to medical care for persons with human immunodeficiency virus receiving care in the United States
    Cunningham, WE
    Andersen, RM
    Katz, MH
    Stein, MD
    Turner, BJ
    Crystal, S
    Zierler, S
    Kuromiya, K
    Morton, SC
    St Clair, P
    Bozzette, SA
    Shapiro, MF
    [J]. MEDICAL CARE, 1999, 37 (12) : 1270 - 1281
  • [7] Barriers and facilitators to exercise among stroke survivors
    Damush, Teresa M.
    Plue, Laurie
    Bakas, Tamilyn
    Schmid, Arlene
    Williams, Linda S.
    [J]. REHABILITATION NURSING, 2007, 32 (06) : 253 - +
  • [8] Chronic disease self-management for individuals with stroke, multiple sclerosis and spinal cord injury
    Hirsche, Robert C.
    Williams, Beverly
    Jones, Allyson
    Manns, Patricia
    [J]. DISABILITY AND REHABILITATION, 2011, 33 (13-14) : 1136 - 1146
  • [9] Recovery following stroke: The role of self-management education
    Kendall, Elizabeth
    Catalano, Tara
    Kuipers, Pim
    Posner, Natasha
    Buys, Nicholas
    Charker, Jill
    [J]. SOCIAL SCIENCE & MEDICINE, 2007, 64 (03) : 735 - 746
  • [10] The PHQ-9 - Validity of a brief depression severity measure
    Kroenke, K
    Spitzer, RL
    Williams, JBW
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 2001, 16 (09) : 606 - 613