Gerontology Institute, College of Arts and Sciences, Georgia State University , Atlanta, GA , USA.
Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, GA , USA.
Front Public Health. 2015 Apr 27;2:174. doi: 10.3389/fpubh.2014.00174. eCollection 2014.
Older African Americans carry a disproportionate share of chronic diseases. The purpose of this study was to identify the characteristics of urban-dwelling African Americans with chronic disease participating in Chronic Disease Self-Management Education (CDSME) programs and to examine factors related to successful program completion (i.e., attending at least four of the six sessions).
Data were analyzed from 11,895 African Americans who attended a CDSME program at one of the five leading delivery sites (i.e., senior center, health care organization, residential facility, community location, faith-based organization). Logistic regression analyses were used to assess the associations of demographic, delivery site, and neighborhood characteristics with CDSME program successful completion.
Approximately, half of the African American participants were aged 65-79 years, 83% were female, and 92% lived alone. Approximately, 44% of participants had three or more chronic conditions and 35% resided in an impoverished area (i.e., 200% below federal poverty level). Successful completion of the CDSME program was associated with being between the ages of 50-64 and 65-79 years, being female, living alone, living in an impoverished community, and attending a CDSME program at a residential facility or community center.
Findings highlight the unique patterns of attendance and delivery within the context of self-management interventions among this unique and traditionally underserved target population. Understanding such patterns can inform policy and practice efforts to engage more organizations in urban areas to increase CDSME program adoption. Particularly, employing strategies to implement CDSME programs across all delivery site types may increase reach to African American participants.
年龄较大的非裔美国人患有多种慢性疾病的比例过高。本研究的目的是确定参与慢性疾病自我管理教育(CDSME)计划的城市非裔美国人的特征,并研究与成功完成计划(即至少参加六节课程中的四节)相关的因素。
对参加五个主要提供点(即老年中心、医疗机构、居住设施、社区地点、宗教组织)之一的 CDSME 计划的 11895 名非裔美国人的数据进行了分析。使用逻辑回归分析评估人口统计学、提供地点和邻里特征与 CDSME 计划成功完成的关联。
约一半的非裔美国参与者年龄在 65-79 岁之间,83%为女性,92%独居。约 44%的参与者有三种或三种以上的慢性疾病,35%居住在贫困地区(即联邦贫困线以下 200%)。成功完成 CDSME 计划与年龄在 50-64 岁和 65-79 岁之间、女性、独居、居住在贫困社区以及在居住设施或社区中心参加 CDSME 计划有关。
研究结果突出了在这一独特且传统上服务不足的目标人群中,自我管理干预措施背景下的独特参与和提供模式。了解这些模式可以为政策和实践努力提供信息,以鼓励更多的组织参与城市地区,增加 CDSME 计划的采用。特别是,采用策略在所有提供点类型中实施 CDSME 计划可能会增加非裔美国参与者的覆盖面。