Chronic Disease Self-Management Program

Self-Management Resource Center

Overview

The Chronic Disease Self-Management Program (CDSMP) is a direct education intervention that helps individuals and caregivers of those with chronic health conditions build a “toolbox” of strategies they can utilize to help achieve their health goals. Workshops are for adults and are highly participatory and build mutual support. Workshop topics include techniques to deal with symptoms of chronic conditions, such as fatigue, pain, sleeplessness, shortness of breath, stress, and emotional problems, such as depression, anger, fear, and frustration. Participants will learn appropriate exercise for maintaining and improving strength and endurance, falls prevention, healthy eating, better breathing techniques, appropriate use of medication, working more effectively with health care providers, communication skills, action planning, problem solving, and decision making. Through actively achieving small goals, participants obtain success which builds confidence in their ability to manage their health and maintain active, fulfilling lives. 

Please Note: Medical nutrition therapy is not allowable for SNAP-Ed. We strongly recommend you partner with a healthcare professional to provide those components of this intervention. Components focused on healthy eating and physical activity are appropriate for SNAP-Ed. 

Target Behavior: Healthy Eating, Physical Activity and Reduced Screen Time 

Intervention Type: Direct Education 

Intervention Reach and Adoption

The CDSMP specifically addresses the needs of SNAP-Ed adults as it is typically offered free of cost (or low cost) in community settings, such as churches, libraries, or on site in community housing settings. The program is also offered virtually allowing those with transportation barriers to have access from their home where internet is available. Finally, it can be offered in small group phone calls accompanied by a mailed kit of print and audio materials.  It is a peer lead intervention, which helps to build trust and empathy in the group. The programs were developed based on focus groups with potential participants, reviewing professional organizational standards and national standards for areas such as exercise and nutrition. Combined, these inputs with processes increase self-efficacy and allow participants to self-tailor the workshops to their own needs. CDSMP is also available in several languages including, Spanish, English, Chinese, and French. 

Setting: Community, Worksites, Faith-based community, Health care, Food pantries, Worksite, Indian Tribal Organizations 

Target Audience: Adults 

Race/Ethnicity: All 

Intervention Components

The small group workshop (8-16 participants) is offered either face-to-face or virtual for 2.5 hours once a week for six weeks. Virtual workshops are 8-12 participants and telephone workshops are 3-5 participants. Workshops are facilitated by 2 trained leaders, one or both of whom are non-health professionals with a chronic condition themselves or experience supporting someone with a chronic condition. Leaders must be trained by Self-Management Resource Center certified Master Trainers. The workshop topics include techniques to deal with symptoms of chronic conditions (e.g., fatigue, pain, and emotional problems, such as depression), and participants learn appropriate exercises for maintaining and improving strength and endurance, falls prevention, healthy eating, better breathing techniques, appropriate use of medication, working more effectively with health care providers, communication skills, action planning, problem solving, and decision making. Participants are highly encouraged to participate in brainstorming, problem solving, and action planning and decision-making activities throughout. 

Intervention Materials

Each participant receives a Living a Healthy Life with Chronic Conditions book which expands upon topics introduced in the workshop setting. CDSMP must be implemented by a Self-Management Resource Center (SMRC) licensed entity.  

Intervention Costs

There is a fee to maintain a program license through the SMRC. With licensing comes opportunities to access program leader materials. Full information is available at https://selfmanagementresource.com/ 

Participant materials include a textbook and CD/MP3 that also have a cost associated. The participant materials can be purchased from the publisher at: https://www.bullpub.com/living-a-healthy-life-with-chronic-conditions-5th-edition.html, or from a source such as Amazon. 

Evidence Summary

The program was developed by the Stanford University School of Medicine and involved many community partners such as the U.S. National Arthritis Foundation and Kaiser Permanete. Participants in the randomized trial of the CDSMP completed a pre-survey and then a post-survey at 6 months post completion. There is strong evidence across studies that CDSMP has a beneficial effect on physical and emotional outcomes, and health‐related quality of life. This statement is based on high‐quality information, standardized measures and is made with a high degree of confidence. The program consistently results in greater energy/reduced fatigue, more exercise, fewer social role limitations, better psychological well‐being, enhanced partnerships with physicians, improved health status, and greater self-efficacy.  It is generally (although not always) associated with reductions in pain symptoms. These findings have been replicated in at least five other longitudinal studies.  

Chronic Disease Self-Efficacy Scales (survey):  

Review of Findings on CDSMP Outcomes: 

Articles about the CDSMP: 

Southern NH Area Health Education Center Fall 2020 Semi-Annual Report: 

Evidence-based Approach: Research-tested 

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
MT1, MT2, MT3 LT3 R11
Environmental Settings
Sectors of Influence
  • LT3: Physical Activity and Reduced Sedentary Behavior 
    • Reliable data shows that participants have increased physical activity and maintained the increase 6-month post workshop 
  • R11-b: Proportion of SNAP-Ed eligible adults or youth who self-report good or better mental health 
    • Significant improvement reported of improved mental health at 6-month post workshop 

Evaluation Materials

Participants take a pre workshop survey and a post survey at 6 months. Southern NH AHEC collects this data and produces a report highlighting the program results on a semi-annual basis.  

A link to the survey tool is here: https://selfmanagementresource.com/wpcontent/uploads/2019/07/English_-_chronic_disease_self-efficacy_scales_32.pdf  

Additional Information

Website: The Chronic Disease Management Program website (https://selfmanagementresource.com) includes more details regarding training, licensing, and program implementation.  

Contact Person(s): 

Self-Management Resource Center
Email: smrc@selfmanagementresource.com
Phone: 650-242-8040