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Factors Associated with the Initiation and Retention of Patients with Lupus in the Chronic Disease Self-Management Program.

OBJECTIVE
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.


METHODS
We studied 228 Black women with SLE who consented to attend a CDSMP workshop. We used logistic regression to calculate unadjusted and adjusted ORs for being a CDSMP initiator (a participant registered into the CDSMP who attended at least one of the first two weekly classes) and a CDSMP completer (a participant who completed >4 of 6 weekly classes).


RESULTS
Majority of partipants were CDSMP initiators (74%, n=168). Of them, 126 (75%) were CDSMP completers. Older age [aOR: 1.03, 95% CI:1.00-1.06] and unemployment/disability [aOR: 2.05, 95% CI: 1.05-4.14] increased the odds of being a CDSMP initiator. The odds of initiating CDSMP decreased by 22% for each additional child in the household [OR: 0.78, 95% CI:0.62-0.98] but this association became non-significant in the adjusted model [aOR: 0.89, 95% CI:0.68-1.18]. The only factor that differed significantly between CDSMP completers and non-completers was age, with 4% higher odds of being a completer for each additional year of age (aOR: 1.04, 95% CI: 1.00-1.07).


CONCLUSION
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 childcare demands.