Article

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: 0.83). 12/2012; 39(4):649-660. DOI: 10.1016/j.pop.2012.08.006
Source: PubMed

ABSTRACT 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.

Download full-text

Full-text

Available from: Adabel Lee, Feb 27, 2014
2 Followers
 · 
99 Views
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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; 2012:973237. DOI:10.1155/2012/973237
  • [Show abstract] [Hide abstract]
    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
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.
    Journal of Clinical Child & Adolescent Psychology 09/2013; 43(2). DOI:10.1080/15374416.2013.836453 · 1.92 Impact Factor
Show more