Testing the Effects of the CDSMP Among Lower-to-Middle Wage Workers
Condition: Chronic Disease
MeSH terms: Chronic Disease
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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:

        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. 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.

        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]).

        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.
    

Intervention name(s): Chronic Disease Self-Management Program (CDSMP); Financial Self-Management Program (FSMP)
Intervention type(s): Behavioral; Behavioral
Other intervention name(s): Health Self-Management Program
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized at the individual level into intervention or attention-control group.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: lower-wage workers; chronic disease; self-management