Factors influencing successful completion of the chronic disease self-management program

The Chronic Disease Self-management Program (CDSMP) is a 6-session workshop designed to address self-management education in persons with chronic disease, including Type 2 diabetes mellitus (T2DM) found disproportionately in underserved and minority populations. Purpose: To identify factors associated with completion of CDSMP. Methods: 113 patients with T2DM (A1c≥7.5) in an HMO in central Texas agreed to participate in a study examining diabetes outcomes associated with CDSMP education. Survey questions included: demographics (race/ethnicity, age, gender, education, income); health-related quality of life (HRQL-4); physical activity (BRFSS); pain/fatigue (visual analog scales); diet, blood sugar testing, and foot care (SDSCA). CDSMP leaders were trained through Stanford University and followed program protocol. Successful completion was attendance at 4-6 sessions. T-tests with Fischer's exact were used to assess differences between two groups, i.e. completers (C) and non-completers (NC). Results: 71% of participants successfully completed CDSMP. T-tests revealed no significant differences between C and NC with regard to age, race/ethnicity, gender, and responses on physical activity, nutrition, blood sugar testing, and foot care. Although not significantly different, C averaged more days per week than NC for almost every positive self-care task: blood sugar testing (5.10 days/wk, 4.96 days/wk); checking feet (4.94, 4.44); healthful eating plan (3.98, 3.48); spacing carbohydrates (3.65, 2.80); and >30 min daily exercise (2.71, 2.26). Conclusion: CDSMP completion was not influenced by race/ethnicity, socioeconomic status, or recent HbA1c - factors linked to health disparities. However, successful CDSMP completion may imply better adherence to diabetes self-care activities across racial/ethnicity groups; further investigation is needed.