Falasinnu Titilola, Bao Gaobin, Brady Teresa J, Lim S Sam, Drenkard Cristina
Stanford University School of Medicine, Palo Alto, California.
Emory University, Atlanta, Georgia.
Arthritis Care Res (Hoboken). 2023 Mar;75(3):519-528. doi: 10.1002/acr.24811. Epub 2023 Jan 10.
The Chronic Disease Self-Management Program (CDSMP) is designed to enhance patients' self-efficacy and skills to manage their chronic illness. There is compelling evidence for the benefits of the CDSMP among patients with systemic lupus erythematosus (SLE); however, little is known about predictors of participation among Black women with SLE. We examined factors associated with CDSMP initiation and completion in this population.
We studied 228 Black women with SLE who consented to attend a CDSMP workshop. We used logistic regression to calculate unadjusted and adjusted odds ratios (ORs) for being a CDSMP initiator (a participant registered into the CDSMP who attended at least 1 of the first 2 weekly classes) and a CDSMP completer (a participant who completed at least 4 of 6 weekly classes).
The majority of participants were CDSMP initiators (74% [n = 168]). Of those, 126 (75%) were CDSMP completers. Older age (adjusted OR [OR ] 1.03 [95% confidence interval (95% CI) 1.00-1.06]) and unemployment/disability (OR 2.05 [95% CI 1.05-4.14]) increased the odds of being a CDSMP initiator. The odds of initiating the CDSMP decreased by 22% for each additional child in the household (OR 0.78 [95% CI 0.62-0.98]), but this association became nonsignificant in the adjusted model (OR 0.89 [95% CI 0.68-1.18]). The only factor that differed significantly between CDSMP completers and noncompleters was age, with 4% higher odds of being a completer for each additional year of age (OR 1.04 [95% CI 1.00-1.07]).
Our findings suggest that young Black women with SLE face barriers to attend and complete in-person CDSMP workshops, possibly in relation to work and child care demands.
慢性病自我管理项目（CDSMP）旨在提高患者管理慢性病的自我效能和技能。有确凿证据表明CDSMP对系统性红斑狼疮（SLE）患者有益；然而，对于患有SLE的黑人女性参与该项目的预测因素知之甚少。我们研究了该人群中与启动和完成CDSMP相关的因素。
我们研究了228名同意参加CDSMP工作坊的患有SLE的黑人女性。我们使用逻辑回归计算成为CDSMP启动者（注册参加CDSMP且至少参加了前两周每周课程中的1节的参与者）和CDSMP完成者（完成了6周课程中至少4节的参与者）的未调整和调整后的优势比（OR）。
大多数参与者是CDSMP启动者（74% [n = 168]）。其中，126人（75%）是CDSMP完成者。年龄较大（调整后的OR [OR] 1.03 [95%置信区间（95%CI）1.00 - 1.06]）和失业/残疾（OR 2.05 [95%CI 1.05 - 4.14]）会增加成为CDSMP启动者的几率。家庭中每增加一个孩子，启动CDSMP的几率降低22%（OR 0.78 [95%CI 0.62 - 0.98]），但在调整模型中这种关联变得不显著（OR 0.89 [95%CI 0.68 - 1.18]）。CDSMP完成者和未完成者之间唯一显著不同的因素是年龄，年龄每增加一岁成为完成者的几率高4%（OR 1.04 [95%CI 1.00 - 1.07]）。
我们的研究结果表明，患有SLE的年轻黑人女性在参加和完成面对面的CDSMP工作坊方面面临障碍，这可能与工作和育儿需求有关。
