Factors Associated with Successful Completion of the Chronic Disease Self-Management Program among Middle-Aged and Older Asian-American Participants: A National Study.

Sangnam Ahn,Jinmyoung Cho,Lindsey Post,Marcia G Ory,Matthew Lee Smith,Luohua Jiang

doi:10.3389/fpubh.2014.00257

Abstract

Asian-Americans are a small but fast-growing population in the United States who are increasingly experiencing multiple chronic diseases. While the evidence-based Chronic Disease Self-Management Program (CDSMP) has been disseminated among various racial and ethnic populations, few studies specifically investigate participants with an Asian background. The study aims to identify characteristics of middle-aged and older Asian-American CDSMP participants (older than 50 years) and investigate factors related to successful workshop completion (i.e., attending 4+ of the 6 sessions) among this population. Data were analyzed from 2,716 middle-aged and older Asian-Americans collected during a 2-year national dissemination of CDSMP. Multilevel logistic regression analyses were conducted to identify individual- and workshop-level covariates related to successful workshop completion. The majority of participants were female, living with others, and living in metro areas. The average age was 71.3 years old (±9.2), and the average number of chronic conditions was 2.0 (±1.5). Successful completion of CDSMP workshops among participants was associated with their number of chronic conditions (OR = 1.10, P = 0.011), living in non-metro areas (OR = 1.77, P = 0.009), attending workshops from area agencies on aging (OR = 1.56, P = 0.018), and attending a workshop with higher completion rates (OR = 1.03, P < 0.001). This study is the first large-scale examination of Asian-American participants enrolled in CDSMP and highlights characteristics related to intervention attendance among this under-studied minority population. Knowing such characteristics is important for serving the growing number of Asian-Americans with chronic conditions.

Highlights

Almost three-quarters of Asian-American adults are foreign-born, representing many countries of origin, including China, India, and the Philippines [1]
Considering individuallevel variables, participants living in non-metro areas had significantly higher completion rates than their urban counterparts (P = 0.009)
The study findings are especially relevant given that Asian-Americans are the fastest-growing population in the U.S The current study reveals that Asian-American participants are similar to other Chronic Disease Self-Management Program (CDSMP) participants in this national dissemination in terms of being predominantly female, living with others, residing in metro areas, and having multiple chronic conditions [7, 11]

Summary

Introduction

Almost three-quarters of Asian-American adults are foreign-born, representing many countries of origin, including China, India, and the Philippines [1] These subgroups constitute the fastest-growing ethnic group in the country, representing almost 6% of the U.S population [1]. Between 2011 and 2012, the rate of population increase was 2.9% for Asian-Americans, 2.2% for Hispanics; 2.2% for Native Hawaiians and Other Pacific Islanders; 1.5% for American-Indians and Alaska Native; and 1.3% for African-Americans [2]. This population growth warrants further study of health conditions among Asian-Americans. As the total population of AsianAmericans increases, it is expected that a greater number of Asian-Americans will suffer from chronic conditions

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