Participation of lower-to-middle wage workers in a study of Chronic Disease Self-Management Program (CDSMP) effectiveness: Implications for reducing chronic disease burden among racial and ethnic minority populations.
Shawn M Kneipp, Lindsey Horrell, Cecilia Gonzales and 4 others
PMID 31168851WHAT IT FOUND
Racial/ethnic minorities and lower-income workers were more likely to complete chronic disease self-management workshops than White or higher-income participants.
However, only 38% of those randomized attended the first session, showing major barriers to starting.
Key findings
01Non-White participants had significantly higher retention rates than White participants across most study stages, with White continuation rates 5% to 15% lower.
02There was a sharp drop in participation after randomization: while 70% of eligible participants completed baseline data collection, only 38% attended the first workshop session.
03Participants from the lowest household income group were more likely to complete the program than those from the highest income group, with representation increasing from 18.7% to 31.7% through completion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study analyzes participation and retention, not the effectiveness of the CDSMP intervention itself. Data on chronic health conditions and multiple job status were only available for those who completed eligibility screening, limiting analysis at earlier stages. The sample was restricted to English-fluent workers in five North Carolina counties earning less than $60,000, which limits generalizability to other regions, income levels, or languages. The low number of participants who attended the first session limited the statistical power for some inferential tests regarding predictors of attendance.
Declared interests
Research Support, U.S. Gov't, P.H.S.
The easy way to misread this
Do not interpret the higher retention rates among minority and low-income participants as evidence that the CDSMP is more effective for these groups. This study reports on who stayed in the program, not on health outcomes or clinical improvement.