Communication Cues to Engage Lower-SES Adults in Self-Management

ABSTRACT Chronic illness disproportionately affects lower-socioeconomic (SES) populations and typically strikes at a younger age than their higher-SES counterparts. This means that many working-age (40-64 years), lower-SES adults face limitations to activity and daily functioning related to the negative physical, mental and emotional effects of living with chronic illness. Evidence-based self-management programs are effective at mitigating the health and economic outcomes of chronic illness amongst this population, yet few have successfully engaged lower-SES, working age adults. Upon further exploration, this lack of engagement could be due to the failure of previous studies to design recruitment materials tailored to the motivations of this vulnerable population who, in addition to managing their chronic illness, typically juggle higher levels of work and family-related demands than younger or older adults. Thus, the purpose of the proposed study is to identify communication cues that effectively engage this underserved population in self-management-related research. This study will be conducted as an ancillary study to a parent randomized control trial (RCT) currently underway at the University of North Carolina at Chapel Hill. This CDC-funded parent-RCT is testing the health and economic benefits of the Chronic Disease Self-management Program amongst lower-income workers ages 40-64. The proposed study will analyze quantitative data gathered from participants of the RCT regarding their preferences for communication cues featured in study advertisements, their processing and appraisal of such cues, their motivation to enroll in the study, and their subsequent enrollment and program participation. The aims of this project are to identify cue preferences that are most highly associated with these five levels of cognitive and behavioral engagement (cue processing, appraisal, motivation, enrollment and program participation) in a study testing a self-management program, to assess the extent to which cognitive engagement constructs (cue processing, appraisal and motivation) are associated with behavioral engagement (enrollment and program participation), and to assess whether key demographic variables moderate the findings of Aims 1 & 2. The results of this research may help answer NINR's Innovative Questions concerning how to translate evidence-based self-management programs to new populations. Furthermore, the knowledge gained during this study may also be used to guide future nurses as they attempt to engage this hard-to-reach demographic not only in self-management research, but in a variety of studies aimed to enhance health behavior.