ABSTRACT
Females are more likely than males to participate in evidence-based health promotion and disease prevention programs targeted for middle-aged and older adults. Despite the availability and benefits of Stanford's Chronic Disease Self-Management Education (CDSME) programs, male participation remains low. This study identifies personal characteristics of males who attended CDSME program workshops and identifies factors associated with successful intervention completion. Data were analyzed from 45,375 male CDSME program participants nationwide. Logistic regression was performed to examine factors associated with workshop attendance. Males who were aged 65-79 (OR = 1.27, p < .001), Hispanic (OR = 1.22, p < .001), African American (OR = 1.13, p < .001), Asian/Pacific Islander (OR = 1.26, p < .001), Native Hawaiian (OR = 3.14, p < .001), and residing in nonmetro areas (OR = 1.26, p < .001) were more likely to complete the intervention. Participants with 3+ chronic conditions were less likely to complete the intervention (OR = 0.87, p < .001). Compared to health-care organization participants, participants who attended workshops at senior centers (OR = 1.38, p < .001), community/multipurpose facilities (OR = 1.21, p < .001), and faith-based organizations (OR = 1.37, p < .001) were more likely to complete the intervention. Men who participated in workshops with more men were more likely to complete the intervention (OR = 2.14, p < .001). Once enrolled, a large proportion of males obtained an adequate intervention dose. Findings highlight potential strategies to retain men in CDSME programs, which include diversifying workshop locations, incorporating Session Zero before CDSME workshops, and using alternative delivery modalities (e.g., online).
Subject(s)
Attitude to Health , Health Promotion/organization & administration , Patient Compliance/ethnology , Patient Compliance/statistics & numerical data , Self-Management/education , Age Factors , Aged , Chronic Disease/therapy , Humans , Incidence , Logistic Models , Male , Needs Assessment , Patient Education as Topic/organization & administration , Program Evaluation , Risk Assessment , Sex Factors , United StatesABSTRACT
CONTEXT: Chronic pain affects approximately 100 million Americans, but little is known about the factors associated with pain frequency. OBJECTIVES: This article examines participants' sociodemographics, medical history, health care access and utilization, self-management barriers, and social support associated with pain frequency among a sample of middle-aged and older adults with one or more chronic condition. METHODS: Data were from the National Council on Aging Chronic Care Survey. An ordinal regression model was fitted to examine factors associated with self-reported pain frequency. RESULTS: Having more chronic conditions (P < 0.001), taking more medication daily (P < 0.001), and visiting the physician five or more times a year (P = 0.011) were associated with more frequent pain. Always getting the help and support needed to manage their health problems was associated with less frequent pain (P < 0.001). CONCLUSION: More attention should be given to pain management during interactions with health care providers. Providing resources and support for disease self-management may help reduce pain frequency and self-management in middle-aged and older adults with chronic conditions.
Subject(s)
Chronic Disease/epidemiology , Pain/epidemiology , Pain/physiopathology , Cross-Sectional Studies , Female , Health Services Accessibility , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Regression Analysis , Risk Factors , Self Report , Self-Management , Social Support , Socioeconomic FactorsABSTRACT
Tobacco smoke exposure has been associated with more frequent hospitalizations in children with sickle cell disease (SCD), but previous studies have not quantified the exposure by objective methods. We enrolled 50 children and young adults with SCD in a retrospective and prospective cohort study and quantified tobacco smoke exposure by objective (salivary cotinine) and survey measures. We used a multivariable negative binomial regression model to evaluate the association between salivary cotinine and hospital admissions. Forty-five percent (22/49) of participants had significant elevation of salivary cotinine (≥ 0.5 ng/ml). The incidence risk ratio (IRR) for hospital admission for those with elevated cotinine was 3.7 (95% CI 1.8-8). Those exposed to secondhand smoke but not primary smokers (cotinine between 0.5 and 10 ng/ml) had a similarly increased risk of hospitalization [IRR 4.3 (95% CI 1.8-10)]. We show that an objective measure of tobacco smoke exposure, salivary cotinine, is strongly associated with the rate of hospital admissions in children and young adults with SCD. This association underscores the importance of screening for tobacco smoke exposure in people with SCD. Further investigation is warranted to determine the mechanisms of and to evaluate interventions to decrease tobacco smoke exposure.
