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Factors Associated With Integrating Self-Management Support Into Primary Care

From the Joan C. Edwards School of Medicine, Marshall University, Department of Family and Community Health, Huntington, West Virginia (Dr Crespo), and South Bend, Indiana (Ms Shrewsberry).

Correspondence to Richard Crespo, PhD, Joan C. Edwards School of Medicine, Marshall University, Department of Family and Community Health, 1600 Medical Center Drive, Suite 1400, Huntington, WV 25701 (crespo{at}marshall.edu).

Purpose

The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care.

Methods

Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. A standardized set of questions was used in the interviews. The data from the interviews were analyzed using content analysis techniques.

Results

One of the principle findings is that self-management support requires putting a system in place, not just adding a new component to primary care. The health centers that fully implemented the self-management program made an organizational commitment to keep self-management on the agenda in management meetings, clinical staff set the example by adopting self-management behaviors, and patient self-management support was implemented in multiple patient care venues.

Conclusion

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

The Diabetes Educator, Vol. 33, No. Supplement 6, 126S-131S (2007)
DOI: 10.1177/0145721707304138


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