Health Care Engagement in Disease Prevention and Management: Factors Influencing Chronic Disease Program Referral Adherence Among Non-Hispanic Black and Hispanic Men With Chronic Conditions.

Abstract

This study aimed to identify factors associated with being referred to an evidence-based disease prevention and management program by a health care provider and adherence to such referrals by non-Hispanic Black and Hispanic men. Utilizing a cross-sectional design, data were collected via an internet-based questionnaire from a national sample of 1,679 non-Hispanic Black and Hispanic men ages 40 years and older with one or more chronic diseases. A 105-item survey assessed program referral and attendance, chronic conditions and medications, disease symptoms, support, communication during physician visit, health care frustrations, disease self-management efficacy, barriers to self-care, helpfulness of learning from others for self-care, and sociodemographics. Binary logistic regression models were fitted to assess factors associated with referrals to a disease prevention and management program and attendance. Results indicated that approximately 23% of participants were referred to a program, and 19.2% reported attendance. Factors associated with being referred to and attending a program included being younger, having more chronic conditions, taking more medications daily, having higher pain scores, reporting more health care frustrations, and reporting better communication with physicians during visits. Men referred to attend a chronic disease program by a health care provider were 16.86 times more likely to attend a chronic disease program (p < .001). These findings suggest the importance of health care engagement for non-clinical disease prevention and management programs, particularly among non-Hispanic Black and Hispanic men with complex disease profiles.