Online Program

National growth and sustainability of the chronic disease self-management program (CDSMP): An incremental examination of delivery characteristics

Monday, November 4, 2013

Matthew Lee Smith, PhD, MPH, CHES, Department of Health Promotion and Behavior, Workplace Health Group, University of Georgia, Athens, GA
Marcia Ory, PhD, MPH, Health Promotion and Community Health Sciences, Texas A&M HSC School of Rural Public Health, College Station, TX
SangNam Ahn, PhD, MPSA, Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN
Kristie Kulinski, MSW, Center for Healthy Aging, National Council on Aging, Washington, DC
Kate Lorig, DrPH, RN, Patient Education Research Center, Stanford School of Medicine, Stanford, CA
Nancy Whitelaw, PHD, The National Council on the Aging, Washington, DC
Background. As part of the American Recovery and Reinvestment Act, Stanford's evidence-based Chronic Disease Self-Management Program (CDSMP) was selected for grand-scale dissemination in 45 states, Washington DC, and Puerto Rico. The primary charge of this effort was to establish a sustainable program delivery system serving middle-aged and older adults with one or more chronic conditions.

Objectives. The current study: (1) identifies personal characteristics of the first 100,000 adults who attended CDSMP workshops; and (2) compares personal and delivery site characteristics associated with CDSMP enrollment in terms of the first, second, third, and fourth group of 25,000 participants reached.

Methods. Data were analyzed from 100,000 adults collected during a two-year national dissemination of CDSMP. Multinomial logistic regression was utilized to compare personal and delivery site characteristics associated with CDSMP workshop enrollment by increments of 25,000 participants.

Results. Among the 100,000 CDSMP participants, 63% were aged 65+, 78% were female, 44% were non-white, and 37% reported 3+ chronic conditions. Most participants attended workshops through the aging services network (29%), healthcare organizations (21%), and residential facilities (18%). The first group of 25,000 participants was reached over 9.4 months, whereas the fourth group of 25,000 participants was reached over 5.3 months. Compared to the first 25,000 participants reached, subsequent groups were significantly more likely to be Hispanic, report more chronic conditions, and reside in areas with more families living in poverty.

Conclusion: This national translational study illustrates the rapid expansion of CDSMP and capability to reach diverse populations in a variety of workshop settings.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify three participant characteristics associated with attending the Chronic Disease Self-Management Program (CDSMP). Identify two delivery site characteristics associated with attending CDSMP. Discuss the time needed to reach large groups of CDSMP participants and the associated implications for program sustainability. Describe three ways in which understanding the reach and adoption of this national CDSMP dissemination can influence future recruitment and retention efforts.

Keyword(s): Chronic Diseases, Disease Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Over the past 6 years, I have had extensive experience implementing and evaluating this evidence-based chronic disease self-management program at the local, state, and national level.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.