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Living Healthy

(i.e. The Chronic Disease Self-Management Program, CDSMP)

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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

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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

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CDSMP – Program Goal

• To enable participants to build self-confidence to assume a major role maintaining their health and managing their chronic health conditions.

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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

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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.

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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

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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

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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

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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.

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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

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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.

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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

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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.

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Contact Information

Serena Weisner, MS CDSMP Project Director

NC Division of Aging & Adult Services

serena.weisner@dhhs.nc.gov

(919) 733-0440