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Abstract Number: 2085

Too Soon to Say: Promising Results from a Community-Delivered RCT Examining Work-Related Outcomes of the Chronic Disease Self-Management Program

Kristina Theis1, Teresa Brady 2 and Shawn Kneipp 3, 1Centers for Disease Control and Prevention, Atlanta, 2Clarity Consulting and Communications, Atlanta, GA, 3School of Nursing, The University of North Carolina at Chapel Hill, Atlanta, GA

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Intervention, Public Health Approach and recruiting, RCT, work

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Session Information

Date: Tuesday, November 12, 2019

Title: Epidemiology & Public Health Poster III: OA, Gout, & Other Diseases – ARP

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: More than two-thirds of U.S. adults with arthritis are working-age (< 65), and arthritis is a leading cause of work disability. The Chronic Disease Self-Management Program (CDSMP) has evidence for improving physical and mental health outcomes, but few studies specifically address employment. We examined work-related outcomes following participation in CDSMP.

Methods: From 6/2016-9/2017, we recruited participants through flyer, e-mail, and digital advertisements in communities, worksites, and other channels. No reference was made to CDSMP; participation was described in either a “health self-management program” or a “financial self-management program” (FSMP). Potential participants consented and enrolled through a website which screened for age (40-64 years), being employed, income, ≥1 chronic condition, English fluency, and living/working in the study area (5 North Carolina counties). Study design was a randomized controlled trial: intervention group=CDSMP, attenuated attention-control group=FSMP. Our primary study outcome was percent work productivity loss due to health-related presenteeism using the Work Limitations Questionnaire (WLQ) 4 Question Time Loss Module and the WLQ 25 Item Online Version. Baseline sample characteristics were summarized using descriptive statistics. Analyses of primary outcomes were conducted using simple t-tests, paired t-tests, and multivariate generalized linear models using an intent-to-treat (ITT) approach. We also did a post hoc analysis comparing CDSMP completers (attended ≥4 of the 6 sessions) to the FSMP group using α=0.10 due to the small sample size of CDSMP completers (n=41).

Results: A total of 327 enrolled and were randomized to CDSMP (n=160) or FSMP (n=167). The sample was predominantly white (54%), female (89%), and college educated (73%), with an average 2.89 chronic conditions, and average household income of $62,009. There were no significant group differences at baseline. Participation rates (attending any portion of program) were 35% (n=56) CDSMP and 25% (n=41) FSMP.

ITT analysis: There were no significant between-group differences in work-related outcomes (e.g., percent work productivity loss, time management, work output, or work self-efficacy) from baseline to 6 or 12-month follow up. In the CDSMP group (vs FSMP) depressive symptoms improved at 6 months (p=0.04) but not at 12 months; general health significantly improved at 12 months (p=0.02) but was clinically negligible.

CDSMP Completer Analysis: Compared to the FSMP group, CDSMP completers reported a greater reduction in percent work productivity loss (p=0.06) and subscales mental/interpersonal tasks (p=0.05) and work output (p=0.07) using α=0.10.

Conclusion: Low participation rates decreased power to find significant differences in the ITT analysis. However, the CDSMP completer analysis suggested a positive effect of CDSMP on work productivity among those who completed ≥4 sessions. A larger sample size of CDSMP completers is necessary to confirm these promising findings.


Disclosure: K. Theis, None; T. Brady, None; S. Kneipp, None.

To cite this abstract in AMA style:

Theis K, Brady T, Kneipp S. Too Soon to Say: Promising Results from a Community-Delivered RCT Examining Work-Related Outcomes of the Chronic Disease Self-Management Program [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/too-soon-to-say-promising-results-from-a-community-delivered-rct-examining-work-related-outcomes-of-the-chronic-disease-self-management-program/. Accessed .
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