Perspectives on Self-Management From the Diabetes Initiative of the Robert Wood Johnson Foundation

Fisher, Edwin B.; Brownson, Carol A.; O’Toole, Mary L.; Anwuri, Victoria V.; Shetty, Gowri

doi:10.1177/0145721707304124

Cited by 38 publications

(44 citation statements)

References 25 publications

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“…Intensity might also be titrated by recipient choice and/or need (e.g., recent widowhood, retirement, or change in clinical status). From this perspective and considering the reality that different people will react positively to different offerings, it may be more important that services include a variety of good practices rather than a limited number of "best practices" (34).…”

Section: Ongoing Supportmentioning

confidence: 99%

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Fisher

Coufal²,

Parada³

et al. 2014

Annu. Rev. Public Health

Self Cite

107

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As reviewed in the article by Perry and colleagues (2014) in this volume, ample evidence has documented the contributions of peer support (PS) to health, health care, and prevention. Building on that foundation, this article discusses characteristics, contexts, and dissemination of PS, including (a) fundamental aspects of the social support that is often central to it; (b) cultural influences and ways PS can be tailored to specific groups; (c) key features of PS and the importance of ongoing support and backup of peer supporters and other factors related to its success; (d ) directions in which PS can be expanded beyond prevention and chronic disease management, such as in mental health or interventions to prevent rehospitalization; (e) other opportunities through the US Affordable Care Act, such as through patientcentered medical homes and chronic health homes; and ( f ) organizational and policy issues that will govern its dissemination. All these demonstrate the extent to which PS needs to reflect its contexts-intended audience, health problems, organizational and cultural settings-and, thus, the importance of dissemination policies that lead to flexible response to contexts rather than constraint by overly prescriptive guidelines.

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Section: Ongoing Supportmentioning

confidence: 99%

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Fisher

Coufal²,

Parada³

et al. 2014

Annu. Rev. Public Health

Self Cite

107

View full text Add to dashboard Cite

show abstract

“…4,5 Structured diabetes education has been shown to improve long-term complications associated with disease morbidity and mortality, and diabetes self-management education (DSME) has emerged as a significant intervention to promote disease management, especially in high-risk populations. [6][7][8] Healthy People serves as the foundation for prevention efforts across the US Department of Health and Human Services. Reducing the disease and economic burden of diabetes and improving the quality of life for all persons who have or are at risk for diabetes is one of its 2020 goals.…”

Section: Original Articlesmentioning

confidence: 99%

Using Accreditation Standards as a Framework to Evaluate and Improve a Community-Based Diabetes Self-Management Education Program

White

Manning

Brawer

et al. 2014

Population Health Management

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“…18,94 Evidence that these community health worker interventions improve outcomes is now available from a number of studies. 89,92,95,96 Partnerships with local public health agencies remain an underused opportunity. Primary care practices and local health departments embrace many of the same prevention goals and provide overlapping care for disadvantaged populations, but they often poorly coordinate their services.…”

Section: Clinical Applicationmentioning

confidence: 99%

Capability and Clinical Success

Ferrer¹,

Carrasco²

2010

The Annals of Family Medicine

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Better outcomes for chronic diseases remain elusive because success depends on events outside the control of the health care system: patients' ability to mange their health behaviors and chronic diseases. Among the most powerful infl uences on self-management are the social and environmental constraints on healthy living, yet the clinical response to these environmental determinants is poorly developed. A potential approach for addressing social determinants in practice, as well as planning and evaluating community responses, is the capability framework. Defi ned as the real opportunity to achieve a desired lifestyle, capability focuses attention on the material conditions that constrain real opportunity and how opportunity emerges from the interaction between personal resources and the social environment. Using examples relevant to chronic disease and behavior change, we discuss the clinical application of the capability framework. CASE HISTORYM rs R. is a 48-year-old Latina who suffers from type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity. She has been regularly attending appointments at the practice for 3 years. Despite ongoing adjustment of her medications, her glycosylated hemoglobin level has never been less than 8.5%. Her history and refi ll intervals suggest that she takes her medications regularly. She has attended nutrition and diabetes education programs. Her physician, Dr M., initially believed that she was motivated to manage her illnesses but is growing increasingly frustrated by the lack of clinical progress. THE EPIDEMIOLOGICAL CONTEXTUnhealthy behaviors and the chronic diseases associated with them account for much of the morbidity and mortality in modern societies. Developing effective solutions is complicated by the burden of morbidity falling most heavily on those with the fewest resources. [1][2][3] Reducing these health disparities has proved especially diffi cult, with little progress during the past 20 years. 4,5 DISCONNECT BETWEEN PROCESS AND OUTCOME IMPROVEMENTSIn the struggle to manage chronic diseases, a growing number of clinical studies point to a disconnect between process-of-care improvements and clinical outcomes. [6][7][8][9] One reason for this disconnect is that success depends on events outside the control of the health care system: patients' ability to alter unhealthy behaviors and manage their diseases.6 The chronic care model therefore emphasizes the importance of patients as active partners. To promote patient participation, clinical strategies have broadened to include more holistic concerns, such as health literacy, [10][11][12][13] self-effi cacy, 14 16 These approaches represent important advances, and they have improved outcomes.12,17 Yet they are themselves limited in scope. They aim to enhance patients' confi dence, motivation, and problem-solving skills, but place less emphasis on evaluating whether the external environment offers real opportunities for change. 18 For example a review of the current national standards for diabetes self-m...

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Perspectives on Self-Management From the Diabetes Initiative of the Robert Wood Johnson Foundation

Abstract: Diabetes Initiative projects have shown that diabetes self-management can be promoted in the "real worlds" of community agencies and primary care settings serving diverse and disadvantaged populations.

Cited by 38 publications

References 25 publications

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Using Accreditation Standards as a Framework to Evaluate and Improve a Community-Based Diabetes Self-Management Education Program

Capability and Clinical Success

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