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Factors contributing to attrition behavior in diabetes self-management programs: a mixed method approach
Enza Gucciardi1, Margaret Demelo, Ana Offenheim
1Ryerson University, School of Nutrition, Toronto, Ontario, Canada. egucciar@ryerson.ca
BMC Health Services Research
|February 6, 2008
Summary
High attrition in diabetes self-management education (DSME) programs is common. Factors like work schedules and confidence in self-management contribute to patients leaving, necessitating accessible services and better physician partnerships.
Area of Science:
- Endocrinology
- Public Health
- Behavioral Science
Background:
- Diabetes self-management education (DSME) is crucial for diabetes care.
- High attrition rates in DSME programs hinder effective diabetes management.
- Understanding attrition factors is vital for improving program engagement.
Purpose of the Study:
- To examine factors contributing to attrition in diabetes self-management programs.
- To identify predictors of premature withdrawal from DSME.
- To explore patient-reported reasons for discontinuing diabetes education services.
Main Methods:
- Telephone interviews with 267 individuals with Type 2 diabetes.
- Multivariable logistic regression to identify attrition predictors.
- Content analysis of open-ended responses from 118 participants who withdrew.
Main Results:
- Working status, age over 65, having a primary care physician, and fewer diabetes symptoms were associated with attrition.
- Key reasons for attrition included work-schedule conflicts, high self-efficacy, apathy, distance, forgetfulness, and low perceived diabetes seriousness.
- Quantitative and qualitative findings showed significant overlap, reinforcing identified attrition factors.
Conclusions:
- Strategies to reduce attrition should focus on service accessibility and convenience.
- Improving patient familiarity with services and enhancing communication are essential.
- Stronger partnerships between diabetes centers and primary care physicians can mitigate attrition.
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