Self-management programs conducted within a practice setting: Who participates, who benefits and what can be learned?

Packer, Tanya; Boldy, Duncan; Ghahari, Setareh; Melling, Lauren; Parsons, Richard; Osborne, Richard H.

doi:10.1016/j.pec.2011.09.007

Cited by 41 publications

(40 citation statements)

References 31 publications

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“…At the same time, integration of self-management support initiatives in regular health practices is hard to achieve [17]. It represents a challenging task for local authorities and health professionals [7,18,19]. Several studies describe adaptation of an existing programme as an approach often used to develop new support programmes [20-22].…”

Section: Introductionmentioning

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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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: Introductionmentioning

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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“…6 Reluctance by physicians to refer patients to self-management programs has been identified in the literature and may result in part from uncertainty as to which of their patients might benefit. 35,36 This reluctance underlines the need for developing a dialogue between self-management programs and family physicians. LHC continues to market the program to health care providers in secondary and primary care, as well as other health and social care organizations.…”

Section: Discussionmentioning

confidence: 99%

Implementation and evolution of a regional chronic disease self-management program

Liddy

Johnston

Nash

et al. 2016

Can J Public Health

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OBJECTIVE: To establish a comprehensive, community-based program to improve and sustain self-management support for individuals with chronic diseases and complement office-based strategies to support behaviour change.PARTICIPANTS: Health service delivery organizations. SETTING:The Champlain Local Health Integration Network (LHIN), a health district in Eastern Ontario. INTERVENTION:We created Living Healthy Champlain (LHC), a regional organization providing peer leader training and coordination for the group Stanford Chronic Disease Self-Management Program (CDSMP); skills training and mentorship in behaviour change approaches for health care providers; and support to organizations to integrate self-management support into routine practice. We used the RE-AIM framework to evaluate the overall program's impact by exploring its reach, effectiveness, adoption, implementation and maintenance. OUTCOME: A total of 232 Stanford CDSMP sessions (63 during the pilot project and 169 post-pilot) have been held at 127 locations in 24 cities across the Champlain LHIN, reaching approximately 4,000 patients. The effectiveness of the service was established through ongoing evidence reviews, a focus group and a pre-post utilization study of the pilot. LHC trained over 300 peer volunteers to provide the Stanford CDSMP sessions, 98 of whom continue to actively host workshops. An additional 1,327 providers have been trained in other models of self-management support, such as Health Coaching and Motivational Interviewing. Over the study period, LHC grew from a small pilot project to a regional initiative with sustainable provincial funding and was adopted by the province as a model for similar service delivery across Ontario. CONCLUSION:A community-based self-management program working in partnership with primary care can be effectively and broadly implemented in support of patients living with chronic conditions. KEY WORDS: Self-management; self-care; chronic disease; behavior change La traduction du résumé se trouve à la fin de l'article.

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“…Even though the number of sessions and demands of the intervention were comparable or less than seen in other self-management programs, 38,46 the burden and effort required to attend and participate in these sessions for individuals with SCI partially explained the fact that only the experimental group experienced attrition.…”

Section: Limitationsmentioning

confidence: 94%

Development and Feasibility ofHealth Mechanics: A Self-Management Program for Individuals with Spinal Cord Injury

Meade

Trumpower

Forchheimer

et al. 2016

Topics in Spinal Cord Injury Rehabilitation

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Objective: We conducted a pilot study to examine the feasibility of administering an individual, in-person version of Health Mechanics, an innovative self-management program designed to teach individuals with spinal cord injury (SCI) to maintain physical health and prevent secondary conditions. Methods: After baseline assessments, 27 participants were randomized using a 2:1 block design to either the experimental intervention or a usual care group. Thirteen of the 19 participants in the intervention group completed the program. Follow-up assessments were completed at 3 and 6 months after baseline. Results: Results suggest that the Health Mechanics intervention delivered in an in-person format was perceived as useful and relevant in addressing a diverse range of health issues with participants with a wide range of personal and impairment characteristics. However, attrition rates and barriers to recruitment suggested limitations in the acceptability of the format for this population. Conclusion: Additional research is needed to identify the populations that would most benefit from the program and the most efficacious context for administration.

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Self-management programs conducted within a practice setting: Who participates, who benefits and what can be learned?

Cited by 41 publications

References 31 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

Implementation and evolution of a regional chronic disease self-management program

Development and Feasibility ofHealth Mechanics: A Self-Management Program for Individuals with Spinal Cord Injury

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