title: The role of session zero in successful completion of chronic disease self-management program workshops.
abstract: BACKGROUND
  The Chronic Disease Self-Management Program (CDSMP) has been widely disseminated among various racial and ethnic populations. In addition to the six required CDSMP workshop sessions, the delivery sites have the option to offer a Session Zero (or zero class), an information session offered prior to Session One as a marketing tool. Despite assumptions that a zero class is helpful, little is known about the prevalence of these additional sessions or their impact on retaining participants in CDSMP workshops. This study aims to describe the proportion of CDSMP workshops that offered Session Zero and examine the association between Session Zero and workshop completion rates.
  
  
  METHODS
  Data were analyzed from 80,987 middle-aged and older adults collected during a two-year national dissemination of CDSMP. Generalized estimating equation regression analyses were conducted to assess the association between Session Zero and successful workshop completion (attending four or more of the six workshop sessions).
  
  
  RESULTS
  On average, 21.04% of the participants attended workshops that offered Session Zero, and 75.33% successfully completed the CDSMP workshop. The participants of the workshops that offered Session Zero had significantly higher odds of completing CDSMP workshops than those who were not offered Session Zero (OR = 1.099, P = <0.001) after controlling for participants' demographic characteristics, race, ethnicity, living status, household income, number of chronic conditions, and workshop delivery type.
  
  
  CONCLUSIONS
  As one of the first studies reporting the importance of an orientation session for participant retention in chronic disease management intervention projects, our findings suggest offering an orientation session may increase participant retention in similar translational efforts.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M Health Science Center , College Station, TX , USA.
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, GA , USA.
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Department of Statistics, Texas A&M University , College Station, TX , USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Chen
authors.affiliation: Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, TN , USA ; Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center , College Station, TX , USA.
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: National Council on Aging , Washington, DC , USA.
authors.forename: Kristie P
authors.initials: KP
authors.lastname: Kulinski
authors.affiliation: Stanford Patient Education Research Center, Department of Medicine, Stanford School of Medicine , Palo Alto, CA , USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
authors.affiliation: Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center , College Station, TX , USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
keywords: attrition; chronic disease self-management program; evidence-based programs; orientation session; retention