Factors Associated With Integrating Self-Management Support Into Primary Care

Crespo, Richard; Shrewsberry, Molly

doi:10.1177/0145721707304138

Cited by 17 publications

(17 citation statements)

References 16 publications

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“…It would also provide guidance for implementation and practice outcomes. A broader understanding of self-management support, as a supplement to medical treatment, reflected a need to put emphasis on what Crespo [36] called “getting a system into place”. The users interpreted a structured system to represent an assurance for a sustainable provision.…”

Section: Discussionmentioning

confidence: 99%

“…Then the demands on personnel resources would probably increase and the sustainability of a support programme in primary health care would still be vulnerable. Therefore, to achieve positive outcomes, integration of a new and supplemental support programme into the regular health system should be enhanced [36]. According to Renders [37] dedicated roles for team members would be one strategy to enhance the health providers’ awareness of self- management support.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Solberg

Steinsbekk

Solbjør

et al. 2014

BMC Health Serv Res

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BackgroundDevelopment of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users’ and health professionals’ perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why.MethodsFour qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method.ResultsThe results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes.ConclusionsThe development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients’ every-day life situations. The user informants’ perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals’ competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Solberg

Steinsbekk

Solbjør

et al. 2014

BMC Health Serv Res

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“…Integration of self-management support into existing care appears more effective if combined with organizational strategies such as reimbursement policies, a multidisciplinary approach and appropriate training for clinicians (blakeman et al 2006; Commissaire à la santé et au bien-être 2010;dennis et al 2008;Harris et al 2008). Evidence also suggests that organizational characteristics such as a higher practice volume, multidisciplinary care teams and use of information technology (reminder systems, patient registries) have a positive impact on the delivery of preventive services and self-management interventions (Crespo and Shrewsberry 2007;Hung et al 2006;O'Connor et al 2008). However, research is scarce in this area, and is needed to guide changes in organizational structures and resources that can foster patient self-management.…”

Section: Résumémentioning

confidence: 99%

Are Primary Healthcare Organizational Attributes Associated with Patient Self-Efficacy for Managing Chronic Disease?

Lemieux

Lévesque²,

Ehrmann-Feldman³

2011

hcpol

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Our objective was to explore how individual and primary healthcare (PHC) organizational attributes influence patients' ability in chronic illness self-management. We conducted a cohort study, recruiting 776 adults with chronic disease from 33 PHC settings in the province of quebec. Organizational data on the PHC clinics were obtained from a prior study. Participants were interviewed at baseline, 6 and 12 months, responding to questionnaires on self-efficacy, health status, socio-demographics, healthcare use and experience of care. multilevel modelling showed that 52.5% of the variance in self-efficacy occurs at the level of

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“…Program champion support from mid-level or top-level managers is necessary for enabling practice change. (Berenson et al, 2008; Crespo & Shrewsberry, 2007; Ploeg, Davies, Edwards, Gifford, & Miller, 2007; Wang, Hyun, Harrison, Shortell, & Fraser, 2006) Although interviewees acknowledged leadership support, the lack of physical presence of leaders dampened their enthusiasm. Ideally, identifying multiple champions in settings with high turnover and unmet demand could help promote and sustain future changes.…”

Section: Discussionmentioning

confidence: 99%

Frontline Experiences of a Practice Redesign to Improve Self-management of Obesity in Safety Net Clinics

AuYoung

Duru

Ponce

et al. 2015

Journal of Ambulatory Care Management

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Background Teamlets of physicians and medical assistants may help improve obesity management in primary care settings. We aimed to understand the barriers and facilitators of implementing a teamlet approach to managing obesity in three safety net clinics. Methods Key stakeholder interviews (n=21) were conducted both during early implementation of practice change and six months later; Patient surveys (n=393) examined obese patient activation and health status. Results Insufficient program resources and limited patient engagement due to external factors were implementation barriers, despite fairly high patient activation. Discussion Staff members need time and resources to execute new responsibilities to support obesity management in safety net settings. Due to high turnover, multiple supporters may improve sustainability.

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Factors Associated With Integrating Self-Management Support Into Primary Care

Abstract: Primary care centers with limited financial resources are able to integrate self-management support into their system of chronic illness care.

Cited by 17 publications

References 16 publications

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Are Primary Healthcare Organizational Attributes Associated with Patient Self-Efficacy for Managing Chronic Disease?

Frontline Experiences of a Practice Redesign to Improve Self-management of Obesity in Safety Net Clinics

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