Testing the Effects of the CDSMP Among Lower-to-Middle Wage Workers
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 327
- 试验地点
- 2
- 主要终点
- Mean Work Limitations Questionnaire-25 Score 6M: Percent productivity loss due to presenteeism
研究概览
简要总结
The purpose of the proposed research is to extend the CDSMP to lower-wage populations aged 40-64 years by partnering with public libraries and employment support networks in select North Carolina counties. The specific aims of this research are to (1) test the effects of the CDSMP on employment and health outcomes among lower-wage working adults 40-64 years of age at 6 and 12 months from baseline, and explore the extent to which they are modified by select sociodemographic, chronic condition, and work-related factors, (2) conduct an economic evaluation of the CDSMP for employers (return on investment [ROI]), the health care system (ROI), and state governments (cost-effectiveness analysis (CEA)), and (3) assess factors associated with the reach, effectiveness, adoption, and implementation of the CDSMP among lower-wage workers using social marketing strategies designed to overcome program engagement and participation challenges that exist in this population.
详细描述
To evaluate the CDSMP's effect on key employment outcomes, an experienced team from the UNC-CH Prevention Research Center (PRC) will leverage its long-standing partnerships with employer networks, public libraries and community agencies throughout the state and the NC Division of Aging's network of 500 active CDSMP interventionists to conduct the proposed work. This research will produce new knowledge about CDSMP effects by (1) testing it in a high chronic disease burden population of employed, lower-wage adults in their preretirement years (ages 40-64), (2) focusing on employment productivity and cost-specific outcomes that would have direct relevance for employers, insurers, and policy-makers, and (3) targeting recruitment and CDSMP delivery to enhance uptake by lower-wage workers. The specific aims of the proposed study are to:
- Test the effects of the CDSMP on employment and health outcomes among lower-wage working adults 40-64 years of age at 6 and 12 months from baseline, and explore the extent to which they are modified by select sociodemographic, chronic condition, and work-related factors. The primary study outcome is work productivity, measured as lost productivity time using Health and Work Performance Questionnaire (HPQ) absenteeism and presenteeism scores. Secondary study outcomes reflect health dimensions that are typically evaluated in relation to CDSMP delivery, and include measures of: chronic disease management self-efficacy, self management behaviors, health status, and healthcare utilization.
- Conduct an economic evaluation of the CDSMP for employers (return on investment [ROI]), the health care system (ROI), and state governments (cost-effectiveness analysis [CEA]).
- Assess factors associated with the reach, effectiveness, adoption, and implementation of the CDSMP among lower-wage workers using social marketing strategies designed to overcome program engagement and participation challenges that exist in this population.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 40 Years 至 64 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •40-64 years of age,
- •residing within one of the 3 study counties,
- •being employed 32 hours or more per week,
- •being able to speak, read, and write in English,
- •earning less than $60,000/year, and
- •self-reporting having been diagnosed with at least one of the following chronic diseases: arthritis (osteoarthritis, rheumatoid, or gout); diabetes (Type I or II); cardiovascular disease; stroke; lung disease; chronic musculoskeletal-related pain; recurrent tension, migraine, or chronic daily headaches; HIV; Crohn's disease; depression; anxiety or panic attacks; post-traumatic stress disorder; or bipolar disorder.
排除标准
- •unable to follow study instructions,
- •severely disruptive, offensive, or socially inappropriate during group CDSMP workshops, or
- •experiences an illness or injury during the study period that results in severe cognitive impairment.
研究组 & 干预措施
CDSMP
Chronic Disease Self-Management Program (CDSMP) - a 6-week, group-based behavioral intervention delivered in a 2.5 hour session each week by a trained facilitator.
干预措施: Chronic Disease Self-Management Program (CDSMP) (Behavioral)
Financial Self-Management
Financial self-management course delivered in 3 modules, with a delivery time of approximately 1 hour per module.
干预措施: Financial Self-Management Program (FSMP) (Behavioral)
结局指标
主要结局
Mean Work Limitations Questionnaire-25 Score 6M: Percent productivity loss due to presenteeism
时间窗: 6 months
The Work Limitations Questionnaire (WLQ) is a patient self-rated scale designed to assess on the- job impact of chronic health problems and/or treatment. The WLQ consists of 25 items in 4 dimensions: limitations handling time (5 items), physical work demands (6 items), mental interpersonal work demands (9 items), and output demands (5 items). Each item is rated on a 5- point scale from "All of the Time" (score 5) to "None of the Time" (score 0), or "Does Not Apply to My Job". The WLQ Productivity Loss Score is derived from the Global Productivity Index, which is calculated as a weighed sum of the 4 dimensions. Reduction in WLQ Productivity Loss score indicates less work limitation and represents the estimated percentage of productivity loss in the past two weeks due to presenteeism relative to a healthy benchmark sample. WLQ Productivity Loss Score ranges from 0% to 24.9%. Higher percent productivity loss reflects more severe work limitations.
Mean Work Limitations Questionnaire-4 Score 6M: Percent productivity loss due to absenteeism
时间窗: 6 months
The percentage of productivity lost due to work absences is the ratio of total missed work hours to total usual work hours in a two-week time frame. Both the numerator (total missed work hours due to health problems or medical care) and the denominator (total usual work hours) are computed based on information from four survey questions (two required and two optional), which are included in the WLQ Work Absence Module. Productivity loss due to absenteeism can range from 0% to 100%, with higher percent loss meaning more absenteeism.
Mean Work Limitations Questionnaire-4 Score 12M: Percent productivity loss due to absenteeism
时间窗: 12 months
The percentage of productivity lost due to work absences is the ratio of total missed work hours to total usual work hours in a two-week time frame. Both the numerator (total missed work hours due to health problems or medical care) and the denominator (total usual work hours) are computed based on information from four survey questions (two required and two optional), which are included in the WLQ Work Absence Module. Productivity loss due to absenteeism can range from 0% to 100%, with higher percent loss meaning more absenteeism.
Mean Work Limitations Questionnaire-25 Score 12M: Percent productivity loss due to presenteeism
时间窗: 12 months
The Work Limitations Questionnaire (WLQ) is a patient self-rated scale designed to assess on the-job impact of chronic health problems and/or treatment. The WLQ consists of 25 items in 4 dimensions: limitations handling time (5 items), physical work demands (6 items), mental interpersonal work demands (9 items), and output demands (5 items). Each item is rated on a 5- point scale from "All of the Time" (score 5) to "None of the Time" (score 0), or "Does Not Apply to My Job". The WLQ Productivity Loss Score is derived from the Global Productivity Index, which is calculated as a weighed sum of the 4 dimensions. Reduction in WLQ Productivity Loss score indicates less work limitation and represents the estimated percentage of productivity loss in the past two weeks due to presenteeism relative to a healthy benchmark sample. WLQ Productivity Loss Score ranges from 0% to 24.9%. Higher percent productivity loss reflects more severe work limitations.
次要结局
- Medication adherence Score: Proportions and Means 12M(12 months)
- Mean Communication with Healthcare Provider Score 6M(6 months)
- Mean Communication with Healthcare Provider Score 12M(12 months)
- Mean Depressive Symptom Severity Score: Patient Health Questionnaire-8 12M(12 months)
- Mean Somatic Symptom Severity Score: Patient Health Questionnaire-15 6M(6 months)
- Mean Somatic Symptom Severity Score: Patient Health Questionnaire-15 12M(12 months)
- Medication adherence: Proportions and Means 6M(6 months)
- Mean Minutes per Week of Leisure Time Light or Moderate Exercise Score 6M(6 months)
- Mean Minutes per Week of Leisure Time Vigorous Exercise Score 6M(6 months)
- Mean Minutes per Week of Leisure Time Vigorous Exercise Score 12M(12 months)
- Mean Social Role Activity Limitation Score 6M(6 months)
- Mean Minutes per Week of Leisure Time Light or Moderate Exercise Score 12M(12 months)
- Mean Depressive Symptom Severity Score: Patient Health Questionnaire-8 6M(6 months)
- Mean Self-Rated Global Health Score: U.S. National Health Survey 6M(6 months)
- Mean Physical Health Days Score: Centers for Disease Control and Prevention 6M(6 months)
- Mean Healthy Mental Health Days Score: Centers for Disease Control and Prevention 12M(12 months)
- Mean Social Role Activity Limitation Score 12M(12 months)
- Mean Number of Times Hospitalized 12M(12 months)
- Mean Self-Rated Global Health Score: U.S. National Health Survey 12M(12 months)
- Mean Physical Health Days Score: Centers for Disease Control and Prevention 12M(12 months)
- Mean Healthy Mental Health Days Score: Centers for Disease Control and Prevention 6M(6 months)
- Mean Number of Times Hospitalized 6M(6 months)