Chronic cardiovascular (CV) conditions such as diabetes, hypertension, and hypercholesterolemia in midlife increase the risk for dementia. The African American community bears a disproportionate amount of chronic disease burden, and continues to face disparities across the healthcare spectrum. Improved control of CV risk factors improves both physical and cognitive health, and may provide a means to reducing dementia risk, but evidence shows that difficulty with adherence to treatment recommendations is common. Health self- management programs such as the Chronic Disease Self-Management Program (CDSMP) are designed to addressthis issue by increasing participant health self-efficacy, though few studies have specifically focused on the experiences of African American participants. The overall objective of the proposed study is to identify key elements influencing participation and engagement in a sample of older African American adults with chronic illness who either completed, withdrew, or declined to participate in a modified version of the CDSMP called Living Well Together (LWT). It is hypothesized that the unique modifications of the LWT program positively impacted participation and engagement in this sample. The study proposes to test this hypothesis through a comparison of attendance and attrition rates between the two programs, and identification and description of key facilitating and complicating factors associated with program engagement and attrition, as well as an exploration of the sustained effects on health behaviors. A mixed methods approach will be used to gain insight into the experiences and perspectives of LWT participants and program leaders, and this information will be used to inform the design, development and testing of future interventions targeting healthy aging for minority adults. The long term goal of this study is to address health disparitie in aging and neurodegenerative diseases through improved management of CV risk factors earlier in life, and is in alignment with National Institute of Health and Centers for Disease Control priorities on promoting healthy aging and reducing health disparities in chronic illness.
Understanding the key factors that encourage or discourage engagement and participation in health self- management programs is critical to improving the health of older adults with chronic diseases. The proposed study targets older African American adults with chronic illness in order to understand the specific needs of this population, increase engagement and maintenance of healthy behaviors, and reduce health disparities in chronic illness and dementia.
