Healthier Living With Ongoing Health Problems
(Internet Chronic Disease Self-Management Program)

The Self-Management @ Stanford Healthier Living with Ongoing Health Problems is an online workshop and study given on the Internet. Groups of about 20 people with heart disease, lung disease, or type 2 diabetes participate together. Workshops are facilitated by two trained moderators, one or both of whom are peers with a chronic health condition themselves. Topics covered include: 1) techniques to deal with problems such as frustration, fatigue, pain and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) healthy eating, and, 6) making informed treatment decisions, 7) disease related problem solving, 8) advanced directives.

It is the process in which the online workshop is presented that makes it unique. Sessions are highly participative through email and online discussion boards, where mutual support and success builds the participants' confidence in their ability to manage their health and maintain active and fulfilling lives.

Each workshop is 6 weeks with new lessons each week. Participants are asked to log on at their convenience 2-3 times each week for a total of 1-2 hours. There are no requirements that participants log in at the same time. Each participant in the workshop receives a copy of the companion book, Living a Healthy Life With Chronic Conditions, 3rd Edition.*

Does the Program replace existing programs and treatments?

The online workshop will not conflict with existing programs or treatment. It is designed to enhance regular treatment and disease-specific education such as Better Breathers, cardiac rehabilitation, or diabetes education. In addition, many people have more than one chronic condition. The program is especially helpful for these people, as it gives them the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives.

How was the Program developed?

Self-Management @ Stanford Healthier Living workshop is the online version of the community-based Chronic Disease Self-Management Program (CDSMP), which was developed and evaluated during a five-year randomized, controlled research project completed in 1996. Our current online program is funded by the Robert Wood Johnson Foundation and the Archstone Foundation.

The process of both the online and community-based workshops are based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one's own health. The content of the workshop was the result of focus groups with people with chronic health problems, in which the participants discussed which content areas were the most important to them.

How was the online program evaluated?

We recruited 958 adult study participants in 2002-2003. All participants had a diagnosis of heart disease (excluding uncomplicated hypertension), lung disease, or type 2 diabetes. Qualified participants were randomly assigned to either participate in the workshop or to a control group. Both groups completed 3 online questionnaires about their health status, health care utilization, self-efficacy and self-management behaviors over a 12-month period. The control group did not receive the workshop, but received a gift certificate after completing each questionnaire and the book used in the workshop* at the end of the 12-month period. All data went to a secure, encrypted server dedicated to this study. This ensured privacy of our participants.

This study is complete, and is currently available for licensing. Results have been published.**

*Living a Healthy Life With Chronic Conditions (3rd edition) by Lorig, Holman, Sobel, Laurent, González and Minor (2006) can be ordered from Bull Publishing.

**Lorig KR, Ritter PL, Laurent DD, Plant K. Internet-Based Chronic Disease Self-Management: A Randomized Trial. Medical Care, 44(11), 964-71, 2006.