Pullyblank Kristin, Brunner Wendy, Scribani Melissa, Krupa Nicole, Ory Marcia G, Smith Matthew Lee
Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA.
Decker College of Nursing and Health Sciences, Binghamton University, PO Box 6000, Binghamton, NY 13902, USA.
Prev Med Rep. 2022 Mar 8;26:101761. doi: 10.1016/j.pmedr.2022.101761. eCollection 2022 Apr.
Chronic disease self-management education (CDSME) programs benefit individuals with chronic diseases, including mental health conditions, by improving health-related outcomes and increasing engagement with the health care system. Recruiting individuals with a history of mental health conditions to participate in CDSME is challenging, particularly in rural, underserved areas. Hence, it is important to understand factors associated with the presence of mental health conditions, and impacts of CDSME on patient engagement. This project identifies individual and program-level characteristics, as well as recruitment characteristics, associated with reporting a history of depression and/or anxiety. It also assesses factors related to program engagement and the relationship between completing CDSME and patient activation. Data were collected during CDSME workshops offered in 2019 in a rural region of New York. Of the 421 enrollees who completed survey instruments, 162 reported a history of depression and/or anxiety. Univariate analyses indicated that those reporting a history of depression and/or anxiety were younger, female, in poorer health, had more comorbidities, were Medicaid beneficiaries, and had lower patient activation scores. They also heard about and signed up for the workshop through the internet at higher rates than those not reporting a history of depression and/or anxiety. Multivariable logistic regression modeling indicated age, self-rated health, and number of comorbidities were independent predictors of reporting a history of depression and/or anxiety. Among CDSME completers, patient activation significantly improved regardless of history of depression and/or anxiety. Engaging individuals with mental health conditions in CDSME requires a multimodal recruitment strategy incorporating electronic marketing and registration.
慢性病自我管理教育（CDSME）项目通过改善与健康相关的结果并增加与医疗保健系统的互动，使包括心理健康状况在内的慢性病患者受益。招募有心理健康状况病史的个体参与CDSME具有挑战性，尤其是在农村和服务不足的地区。因此，了解与心理健康状况存在相关的因素以及CDSME对患者参与度的影响非常重要。该项目确定了与报告抑郁和/或焦虑病史相关的个体和项目层面特征以及招募特征。它还评估了与项目参与相关的因素以及完成CDSME与患者激活之间的关系。数据是在2019年纽约农村地区举办的CDSME研讨会上收集的。在421名完成调查问卷的参与者中，162人报告有抑郁和/或焦虑病史。单因素分析表明，报告有抑郁和/或焦虑病史的人更年轻、为女性、健康状况较差、合并症更多、是医疗补助受益人且患者激活得分较低。他们通过互联网听说并报名参加研讨会的比例也高于没有报告抑郁和/或焦虑病史的人。多变量逻辑回归模型表明，年龄、自我评估的健康状况和合并症数量是报告抑郁和/或焦虑病史的独立预测因素。在完成CDSME的人中，无论有无抑郁和/或焦虑病史，患者激活都有显著改善。让有心理健康状况的个体参与CDSME需要一种结合电子营销和注册的多模式招募策略。
