Self-Management Integration in Healthcare Indicators

The rapid growth in chronic disease, in particular multiple chronic conditions (MCC), poses a significant and increasing burden on the health of Americans.   Maximizing the use of proven self-management strategies is a core goal of the Department of Health and Human Services Framework for Addressing Multiple Chronic Conditions.  Yet there is currently no systematic way to assess how much patient self-management (SM) or self-management support (SMS) is occurring.  The purpose of this project was to identify concepts or measures to incorporate into SM/SMS surveillance at the national level.

A multi-step process was used to identify candidate concepts, assess existing measures, and select high priority concepts for further development.  A stakeholder survey, environmental scan, subject matter expert feedback and a stakeholder priority setting exercise were all used to select the high priority concepts for development.  

The stakeholder survey gathered feedback on 32 candidate concepts; 9 concepts were endorsed by more than 66% of respondents.  The environmental scan revealed few existing measures that adequately reflected the candidate concepts, and those that were identified were generally specific to a defined condition and not gathered on a population basis.   Based on the priority setting exercises and environmental scan, we selected one concept from each of 5 levels of behavioural influence (individual, health care system, community, policy, and media) for immediate development as a SM/SMS indicator.  In the past year, a selected committee has crafted four of the five of these indicators with work taking place to bring them to cognitive testing and final wording.