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Canadian Journal of Public Health

, Volume 103, Issue 6, pp e462–e467 | Cite as

Building the Evidence Base for Chronic Disease Self-management Support Interventions Across Canada

  • Sharon JohnstonEmail author
  • Clare Liddy
  • Karina Mill
  • Hannah Irving
Qualitative Research

Abstract

Objective: The objective of this project was to determine how to improve evaluation of self-management support (SMS) in Canada to generate high-quality evidence to guide policy-makers, implementers, providers and participants.

Methods: This project used a multi-method approach, including a scoping and a focused literature review, an internet scan, interviews with key stakeholders, a review of existing theoretical evaluation frameworks and a consensus meeting with experts.

Results: Four themes were identified through the collection and analysis of data: 1) diverse SMS interventions are identifiable; 2) emerging evaluation activity in Canada is limited to mostly disease-specific, clinic-based programs; 3) there is little evaluation capacity among program implementers in Canada; and 4) there is a gap between the evidence and expectations.

Conclusion: Policy-makers, community organizations and health care teams, regional health authorities and, most importantly, people living with chronic conditions, need better evidence about how to support self-management in their communities. Measuring outcomes must be an explicit part of program implementation and development and requires coordinated support. A common evaluation framework may provide researchers, practitioners and decision- or policy-makers with a systems approach to understanding the possible structural and process factors that can affect self-management outcomes, and could support capacity building in evaluation.

Résumé

Objectif: Déterminer comment améliorer l’évaluation du soutien à l’autogestion des soins (SAS) au Canada afin de produire des preuves de haute qualité pour guider les responsables des politiques, les exécutants, les fournisseurs et les participants au SAS.

Méthode: Nous avons utilisé plusieurs méthodes, dont une étude de champ et une revue de la littérature spécialisée, une exploration d’Internet, des entretiens avec des acteurs privilégiés, un examen des cadres d’évaluation théorique existants et une réunion de concertation avec des spécialistes.

Résultats: Quatre thèmes sont ressortis de la cueillette et de l’analyse des données: 1) diverse interventions en SAS sont identifiables; 2) les activités d’évaluation émergentes au Canada se limitent en gros aux programmes cliniques axés sur certaines maladies; 3) les capacités d’évaluation sont minimes chez les exécutants des programmes au Canada; et 4) il y a un écart entre les preuves et les attentes.

Conclusion: Les responsables des politiques, les organismes communautaires et les équipes de soins de santé, les offices régionaux de la santé et, surtout, les personnes vivant avec des maladies chroniques ont besoin de meilleures preuves sur les moyens de soutenir l’autogestion des soins dans leurs communautés. La mesure des résultats doit faire partie intégrante de l’élaboration et de la mise en œuvre des programmes de SAS, et elle exige un soutien coordonné. Un cadre d’évaluation commun pourrait fournir aux chercheurs, aux praticiens et aux décideurs ou responsables des politiques une approche systémique pour comprendre les facteurs structurels et liés aux processus qui pourraient peser sur les résultats de l’autogestion des soins; un tel cadre pourrait aussi appuyer le renforcement des capacités d’évaluation.

Key words

Self-care self-management support chronic disease program evaluation 

Mots clés

autosoins soutien à l’autogestion des soins maladie chronique évaluation de programme 

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Copyright information

© The Canadian Public Health Association 2012

Authors and Affiliations

  • Sharon Johnston
    • 1
    • 2
    Email author
  • Clare Liddy
    • 1
  • Karina Mill
    • 1
  • Hannah Irving
    • 1
  1. 1.Department of Family MedicineUniversity of OttawaOttawaCanada
  2. 2.CT Lamont Primary Health Care Research CentreBruyère Research InstituteOttawaCanada

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