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Feel Better. Take Charge.
Living Healthy
(i.e. The Chronic Disease Self-Management Program, CDSMP)
Feel Better. Take Charge.
Self-management
There is no way [a patient] can avoid managing a chronic condition. If he/she does nothing but suffer, this is a management style. If the patient chooses to be a “positive self-managerpositive self-manager” and undergo all the best treatments that health care professionals have to offer, along with being proactive in his/her day-to-day management, this will lead to the healthiest life possible.
Kate Lorig, RN, DPH, et al. Living A Healthy Life with Chronic Conditions
Feel Better. Take Charge.
Chronic Disease Self-Management Program (CDSMP)
• Evidence-based program developed by Stanford Univ.
• Format: Train the Trainer– Lay Leader Led – teams of 2– 2 ½ hours session; 1x/wk; 6 weeks– 10 – 15 participants
Stanford Univ. / T Trainers
Master Trainers
Lay Leaders
Workshop Participants
Feel Better. Take Charge.
CDSMP – Program Goal
• To enable participants to build self-confidence to assume a major role maintaining their health and managing their chronic health conditions.
Feel Better. Take Charge.
Illustration of self-management problems for a sample of chronic conditions
Chronic Condition
Pain Fatigue
Shortness of Breath
Physical
Function
Emotions
Arthritis X X X X
Asthma/Lung Disease
X X X X
Diabetes X X X X
Heart Disease
X X X X X
Lorig, et al., 2006
Feel Better. Take Charge.
Reasoning behind the program’s design and elements
• People with chronic conditions have similar concerns and problems.
• People with chronic conditions must deal not only with their disease(s), but also with the impact on their lives and emotions.
• Lay people with chronic conditions, when given a detailed leader's manual, can lead the CDSMP as effectively, if not more effectively, than health professionals.
• The process or the way the CDSMP is taught is as important, if not more important, than the subject matter that is taught.
Feel Better. Take Charge.
Essential program components and activities
• Coping strategies incorporated include: – goal setting and feedback– behavior modeling– problem-solving techniques– decision making
• Individuals are taught to control their symptoms through: – Relaxation techniques – Changing their diets– Managing sleep and fatigue – Using medications correctly – Physical activity – Communication with health providers
Feel Better. Take Charge.
Workshop Session Content
Session 1 Session 2 Session 3
1. Introduction
2. Workshop Overview & Responsibilities
3. Differences Between Acute & Chronic Conditions
4. Using Your Mind to Manage Symptoms & Distraction
5. Introduction to Action Plans
6. Closing
1. Feedback / Problem-Solving
2. Dealing with Difficult Emotions
3. Introduction to Physical Activity & Exercise
4. Making an Action Plan
5. Closing
1. Feedback Problem-Solving
2. Better Breathing
3. Muscle Relaxation
4. Pain & Fatigue Management
5. Endurance Activities
6. Making an Action Plan
7. Closing
Feel Better. Take Charge.
Workshop Content, Continued
Session 4 Session 5 Session 6
1. Feedback / Problem-Solving
2. Future Plans for Health Care
3. Healthy Eating
4. Communication Skills
5. Problem-Solving
6. Making an Action Plans
7. Closing
1. Feedback / Problem-Solving
2. Medication Usage
3. Making Informed Treatment Decisions
4. Depression Management
5. Positive Thinking
6. Guided Imagery
7. Making an Action Plan
8. Closing
1. Feedback Problem-Solving
2. Working With Your Health Care Professional and the Health Care System
3. Looking Back and Planning for the Future
4. Closing
Feel Better. Take Charge.
Research Shows That CDSMP Participants…
• Increased their levels of physical activity.
• Developed better coping strategies and symptom management.
• Showed better communication with their physicians.
• Improved their self-rated health and social/role activities,
• Experienced less health distress.
• Had less fatigue.
• Experienced decreased disability.
• Had lower numbers of physician visits and hospitalizations.
Feel Better. Take Charge.
Tremendous National Support
• US Administration on Aging (AoA)– Over $50 million in grants awarded
• Other federal agencies:– CDC– AHRQ– CMS
• Dozens of private funders, including:– Atlantic Philanthropies– John A. Hartford Foundation– Health Foundation of South Florida– Robert Wood Johnson Foundation– Archstone Foundation
Feel Better. Take Charge.
Living Healthy(i.e. CDSMP)
• 3-year demonstration grant from AoA in 2007
– 7 Area Agencies on Aging (AAAs) covering 46
counties
• Have expanded to 7 more AAAs now covering 80
counties
• Will be state wide by the end of 2012
• Working to target hard-to-reach, underserved adults
60+ and offer the program in a wide variety of
settings.
Feel Better. Take Charge.
Current Reach{State wide by the end of 2012}{State wide by the end of 2012}
Transy
lvan
ia
Anson
Beaufort
Bertie
Brunswick
Camden
Carteret
Columbus
Craven
Currituck
Duplin
Edgeco
mb
e
Gaston
Gates
Greene
Halifax
Harnett
Hertford
Hoke
HydeJohnston
Jones
Lee
Lenoir
Lincoln
Martin
Moore
Nash
Northampton
Onslow
Pamlico
Pasquotank
Pender
Perquimans
Pitt
Ric
hm
on
d
Robeson
Sampson
Scotland
Tyrrell
Union
Washington
Wayne
Wilson
Ala
man
ce
Alexander
AlleghanyAshe
Caldwell
Caswell
Catawba
ChathamDavidson
Davie
ForsythFranklinGuilford
Gra
nv
ille
Iredell
Person
Randolph
RockinghamStokesSurry
Van
ce Warren
Watauga Wilkes
Yadkin
Wake
Avery
Cherokee
Clay
Graham
Hen
ders
on
BuncombeMcDowell
Macon
Mitchell
Polk
RutherfordSwain
Madison
Hayw
ood
Yancey
New
Han
ov
er
Chow
an
Cu
mb
erla
ndMon
tgom
ery
Stanly
Mecklen
bu
rg
Cabarrus
Rowan
Cleveland
Burke
Oran
ge
Du
rha
m
Jackson
Bladen
North Carolina CDSMP/Living HealthyProject Map
Dare
Asheville
Winston-SalemRaleigh
Charlotte
Feel Better. Take Charge.
How can youyou get involved in Living Healthy?
• Participate in a Living Healthy workshop!
• Becoming a Lay Leader or help identify people who would be interested in becoming Lay Leaders
• Locate new sites for workshops and/or trainings
• Help us get the word out Refer clients, and mention the program to colleagues, family members, and friends
• Help us connect with people, groups, organizations, etc. that may be interested.
Feel Better. Take Charge.
Contact Information
Serena Weisner, MS CDSMP Project Director
NC Division of Aging & Adult Services
(919) 733-0440