Adoption of Self-Management Interventions for Prevention and Care

Global Center for Children and Families, Semel Institute for Neuroscience and Human Behavior, 10920 Wilshire Boulevard, Suite 350, University of California at Los Angeles, Los Angeles, CA 90024-6521, USA. Electronic address: .
Primary care (Impact Factor: 0.74). 12/2012; 39(4):649-660. DOI: 10.1016/j.pop.2012.08.006
Source: PubMed


Seventy-five percent of health care costs can be attributed to chronic diseases, making prevention and management imperative. Collaborative patient self-management in primary care is efficacious in reducing symptoms and increasing quality of life. In this article, the authors argue that self-management interventions span the continuum of prevention and disease management. Self-management interventions rest on a foundation of 5 core actions: (1) activate motivation to change, (2) apply domain-specific information from education and self-monitoring, (3) develop skills, (4) acquire environmental resources, and (5) build social support. Several delivery vehicles are described and evaluated in terms of diffusion and cost-containment goals.

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Available from: Adabel Lee, Feb 27, 2014
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    • "To allow increased patient responsibilities and involvement in decision-making process, some basic buildings blocks are required: (a) a good information flow, (b) a trust relationship, (c) a power shift between health staff and patients, and (d) problem-solving and decision-making skills [23,27,32]. These skills together with a sense of ownership are crucial for the patients to recognise and deal with their conditions, and not to perceive decisions and solutions as imposed obligations. "
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    ABSTRACT: To improve retention in antiretroviral therapy (ART), lessons learned from chronic disease care were applied to HIV care, providing more responsibilities to patients in the care of their chronic disease. In Tete - Mozambique, patients stable on ART participate in the ART provision and peer support through Community ART Groups (CAG). This article analyses the evolution of the CAG-model during its implementation process. A mixed method approach was used, triangulating qualitative and quantitative findings. The qualitative data were collected through semi-structured focus groups discussions and in-depth interviews. An inductive qualitative content analysis was applied to condense and categorise the data in broader themes. Health outcomes, patients' and groups' characteristics were calculated using routine collected data. We applied an 'input - process - output' pathway to compare the initial planned activities with the current findings. Input wise, the counsellors were considered key to form and monitor the groups. In the process, the main modifications found were the progressive adaptations of the daily CAG functioning and the eligibility criteria according to the patients' needs. Beside the anticipated outputs, i.e. cost and time saving benefits and improved treatment outcomes, the model offered a mutual adherence support and protective environment to the members. The active patient involvement in several health activities in the clinics and the community resulted in a better HIV awareness, decreased stigma, improved health seeking behaviour and better quality of care. Over the past four years, the modifications in the CAG-model contributed to a patient empowerment and better treatment outcomes. One of the main outstanding questions is how this model will evolve in the future. Close monitoring is essential to ensure quality of care and to maintain the core objective of the CAG-model 'facilitating access to ART care' in a cost and time saving manner.
    BMC Public Health 04/2014; 14(1):364. DOI:10.1186/1471-2458-14-364 · 2.26 Impact Factor
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    • "Regardless of training level or setting, effective healthcare providers demonstrate the following functions with patients: (1) provide information to be applied in daily life; (2) build skills; (3) monitor health status; (4) shape positive health behaviors; (5) create social networks that support change; and (6) address environmental barriers (e.g., transport to hospitals) [7]. These tasks can be facilitated by using mobile phones for a specific activity, or by a system of applications that are able to inform, train, monitor, shape, support, or link providers or patients in need of services for a specific health outcome. "
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    ABSTRACT: Millennium Development Goals (MDGs) are unlikely to be met in most low- and middle-income countries (LMIC). Smartphones and smartphone proxy systems using simpler phones, equipped with the capabilities to identify location/time and link to the web, are increasingly available and likely to provide an excellent platform to support healthcare self-management, delivery, quality, and supervision. Smart phones allow information to be delivered by voice, texts, pictures, and videos as well as be triggered by location and date. Prompts and reminders, as well as real-time monitoring, can improve quality of health care. We propose a three-tier model for designing platforms for both professional and paraprofessional health providers and families: (1) foundational functions (informing, training, monitoring, shaping, supporting, and linking to care); (2) content-specific targets (e.g., for MDG; developmentally related tasks); (3) local cultural adaptations (e.g., language). We utilize the Maternal and Child Health (MCH) MDG in order to demonstrate how the existing literature can be organized and leveraged on open-source platforms and provide examples using our own experience in Africa over the last 8 years.
    International Journal of Telemedicine and Applications 12/2012; 2012(7525):973237. DOI:10.1155/2012/973237
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    ABSTRACT: This work-in-progress reports preliminary results of an interview study (n=5) with low SES, rural patients with type 2 diabetes. The paper presents 3 themes and associated design suggestions relating to the high-prevalence of comorbidities, the importance of external support, and the different stages a patient may be in with respect to making lifestyle changes.
    Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2013 7th International Conference on; 01/2013
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