Attrition in Chronic Disease Self-Management Programs and self-efficacy at enrollment

Area of Science:

• Health behavior
• Chronic disease management
• Psychology

Background:

• The Chronic Disease Self-Management Program (CDSMP) aims to enhance self-efficacy among individuals with chronic illnesses.
• A significant number of participants withdraw from CDSMP before program completion, impacting its effectiveness.
• Understanding attrition factors is crucial for improving program retention and outcomes.

Purpose of the Study:

• To investigate factors associated with program attrition in a community-based CDSMP.
• To examine the relationship between baseline self-efficacy, other members' efficacy, and participant dropout.
• To identify demographic and situational factors linked to CDSMP non-completion.

Main Methods:

• Utilized data from the Our Pathways to Health program (Humboldt County, California, 2008-2011).
• Applied Bandura's self-efficacy theory as the conceptual framework.
• Employed logistic regression to analyze associations between self-efficacy and attrition, controlling for other variables.

Main Results:

• Twenty-three percent of participants did not complete the program.
• Lower baseline self-efficacy was significantly associated with increased odds of dropout.
• Other members' efficacy did not show a significant association with dropout.
• Factors such as age, educational disparity, weekday sessions, and activity limitations were linked to attrition.

Conclusions:

• Participants with lower initial self-efficacy are more likely to drop out of the CDSMP.
• Interventions targeting individuals with low self-efficacy may improve program completion rates.
• Further research is needed to develop effective support strategies for at-risk participants.