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慢性病自我管理教育课程:中低收入中年参与者的利用情况。

Chronic disease self-management education courses: utilization by low-income, middle-aged participants.

机构信息

School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

School of Public Health, The University of Memphis, Memphis, Tennessee, USA.

出版信息

Int J Equity Health. 2017 Jun 27;16(1):114. doi: 10.1186/s12939-017-0604-0.

Abstract

BACKGROUND

Individuals living in lower-income areas face an increased prevalence of chronic disease and, oftentimes, greater barriers to optimal self-management. Disparities in disease management are seen across the lifespan, but are particularly notable among middle-aged adults. Although evidence-based Chronic Disease Self-management Education courses are available to enhance self-management among members of this at-risk population, little information is available to determine the extent to which these courses are reaching those at greatest risk. The purpose of this study is to compare the extent to which middle-aged adults from lower- and higher-income areas have engaged in CDSME courses, and to identify the sociodemographic characteristics of lower-income, middle aged participants.

METHODS

The results of this study were produced through analysis of secondary data collected during the Communities Putting Prevention to Work: Chronic Disease Self-Management Program initiative. During this initiative, data was collected from 100,000 CDSME participants across 45 states within the United States, the District of Columbia, and Puerto Rico.

RESULTS

Of the entire sample included in this analysis (19,365 participants), 55 people lived in the most impoverished counties. While these 55 participants represented just 0.3% of the total study sample, researchers found this group completed courses more frequently than participants from less impoverished counties once enrolled.

CONCLUSION

These results signal a need to enhance participation of middle-aged adults from lower-income areas in CDSME courses. The results also provide evidence that can be used to inform future program delivery choices, including decisions regarding recruitment materials, program leaders, and program delivery sites, to better engage this population.

摘要

背景

生活在低收入地区的个人面临着更高的慢性病患病率,而且往往面临着更难以实现最佳自我管理的障碍。在整个生命周期中都存在疾病管理方面的差异,但在中年人群中尤为明显。尽管有基于证据的慢性疾病自我管理教育课程可供该高危人群使用,以增强自我管理能力,但几乎没有信息可以确定这些课程在多大程度上覆盖了风险最高的人群。本研究的目的是比较来自低收入和高收入地区的中年成年人参加 CDSME 课程的程度,并确定低收入中年参与者的社会人口统计学特征。

方法

本研究的结果是通过对在美国 45 个州、哥伦比亚特区和波多黎各开展的社区预防工作:慢性疾病自我管理计划倡议期间收集的二级数据进行分析得出的。在该倡议中,从美国、哥伦比亚特区和波多黎各的 45 个州、10 万名 CDSME 参与者中收集了数据。

结果

在本分析中纳入的整个样本(19365 名参与者)中,有 55 人居住在最贫困的县。虽然这 55 名参与者仅占总研究样本的 0.3%,但研究人员发现,一旦参加课程,这些人完成课程的频率高于来自不那么贫困县的参与者。

结论

这些结果表明需要加强来自低收入地区的中年成年人参加 CDSME 课程的参与度。结果还提供了可以用来为未来的项目交付选择提供信息的证据,包括关于招募材料、项目负责人和项目交付地点的决策,以更好地吸引这一人群。

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