The Chronic Disease Self-Management Program: the experience of frequent users of health care services and peer leaders

Abstract

Background.Large amount of evidence supports the contribution of the Stanford Chronic Disease Self-Management Program (CDSMP) to a global chronic disease management strategy. However, many studies have suggested further exploring of the factors influencing acceptance and completion of participants in this program.Objective.This study aimed to describe and examine factors associated with acceptance and completion rates of the CDSMP among frequent users of health care services, and to highlight the experience of patients and peer leaders who facilitated the program.Methods.A descriptive design with mixed sequential data was used. Acceptance and completion rates were calculated and their relationship with patient characteristics was examined in regression analysis (n = 167). Interviews were conducted among patients who accepted (n = 11) and refused (n = 13) to participate and with the program coordinator. Focus groups were held with the seven peer leaders who facilitated the program. Data were analysed using thematic analysis.Results.Of the 167 patients invited, 60 (36%) accepted to participate in the program. Group format was the most frequent reason to decline the invitation to participate. Twenty-eight participants (47%) completed the program. Participants who dropped out during the program raised different reasons such as poor health and too much heterogeneity among participants. Factors such as location, schedule, content, group composition and facilitation were considered as important elements contributing to the success of the program.Conclusion.The CDSMP could therefore be considered as a self-management support option for this vulnerable clientele, while taking measures to avoid too much heterogeneity among participants to improve completion rates.

Engaging the Underrepresented Sex: Male Participation in Chronic Disease Self-Management Education (CDSME) Programs

“…Findings also suggested that the program context, including the group composition and the delivery site, also impacted participant retention. Similar to other research findings ( Anderson et al, 2016 ; Hudon et al, 2016 ), maintaining session participation to fewer rather than more participants (i.e., smaller groups) and having a higher proportion of men in the group (i.e., limiting group heterogeneity) can help retain male participants. Small groups may make the workshop more interactive and personalized, which may contribute to increasing its perceived relevance and value to program participants inciting them to attend a greater number of sessions.…”

“…It is known that clinical care may be limited or hard to access in nonmetro areas ( Chan, Hart, & Goodman, 2006 ; Rural Health Information Hub, 2017 ). Finally, compared to males with more chronic conditions, males with less chronic conditions may have less doctors’ visits and other barriers related to their illness (e.g., fatigue or pain) that would prevent them from completing the program ( Agency for Healthcare Research and Quality, 2012 ; Hudon et al, 2016 ).…”

“…Strategies are needed to retain the one third of participants not currently completing the CDSME program. The rest of the program participants may face other challenges and barriers that prevent them from regularly attending the program workshop sessions, including scheduling conflicts due to employment and family responsibilities ( Hudon et al, 2016 ; National Council on Aging, 2016 ), duration of the program ( Administration on Aging, 2013 ), and content barriers such as personal relevance and need ( Anderson et al, 2016 ; Hudon et al, 2016 ; Sandlund et al, 2017 ). One solution to address some of these barriers and ensure that the content of the program is relevant to the participants is to offer them Session Zero.…”

(In)Visible illness: A photovoice study of the lived experience of self-managing rheumatoid arthritis

“…The CDSMP and other self-management programs can be community or hospital based and focus on improving patient’s health behaviour through skill mastery, improved confidence and goal setting. While it was initially developed with RA patient cohorts, it has become a standardized program applied across populations and societies [ 24 , 25 ]. Although it has demonstrated benefits, the fidelity of the intervention across cultures, programme retention and recruitment, and its effectiveness in improving patient outcomes in the long-term requires further study [ 25 – 29 ].…”

“…While it was initially developed with RA patient cohorts, it has become a standardized program applied across populations and societies [ 24 , 25 ]. Although it has demonstrated benefits, the fidelity of the intervention across cultures, programme retention and recruitment, and its effectiveness in improving patient outcomes in the long-term requires further study [ 25 – 29 ]. Arguably, the lived experience of self-managing chronic illness and the context in which effective self-management behaviours are adopted—or not—requires further exploration.…”