Ruiz Sarah, Brady Teresa J, Glasgow Russell E, Birkel Richard, Spafford Michelle
NORC at the University of Chicago, 4350 East-West Hwy, Bethesda, MD 20814. E-mail:
Centers for Disease Control and Prevention, Atlanta, Georgia.
Prev Chronic Dis. 2014 Jun 19;11:E103. doi: 10.5888/pcd11.130328.
The rapid growth in chronic disease prevalence, in particular the prevalence of multiple chronic conditions, poses a significant and increasing burden on the health of Americans. Maximizing the use of proven self-management (SM) strategies is a core goal of the US Department of Health and Human Services. Yet, there is no systematic way to assess how much SM or self-management support (SMS) is occurring in the United States. The purpose of this project was to identify appropriate concepts or measures to incorporate into national SM and SMS surveillance.
A multistep process was used to identify candidate concepts, assess existing measures, and select high-priority concepts for further development. A stakeholder survey, an 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 indicated 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. On the basis of the priority setting exercises and environmental scan, we selected 1 concept from each of 5 levels of behavioral influence for immediate development as an SM or SMS indicator.
The absence of any available measures to assess SM or SMS across the population highlights the need to develop chronic condition SM surveillance that uses national surveys and other data sources to measure national progress in SM and SMS.
慢性病患病率的迅速增长，尤其是多种慢性病的患病率，给美国人的健康带来了巨大且不断增加的负担。最大限度地利用已证实的自我管理（SM）策略是美国卫生与公众服务部的核心目标。然而，目前尚无系统的方法来评估美国国内自我管理或自我管理支持（SMS）的实施程度。本项目的目的是确定适用于纳入全国自我管理和自我管理支持监测的概念或指标。
采用多步骤流程来确定候选概念、评估现有指标，并选择高优先级概念以作进一步开发。利益相关者调查、环境扫描、主题专家反馈以及利益相关者优先级设定活动均用于选择高优先级概念进行开发。
利益相关者调查收集了关于32个候选概念的反馈；9个概念得到了超过66%的受访者认可。环境扫描表明，几乎没有现有指标能充分反映候选概念，且已确定的指标通常特定于某一既定疾病，并非基于人群收集。基于优先级设定活动和环境扫描，我们从行为影响的5个层面中各选取了1个概念，立即作为自我管理或自我管理支持指标进行开发。
缺乏可用于评估全人群自我管理或自我管理支持的指标，凸显了开展慢性病自我管理监测的必要性，该监测可利用全国性调查和其他数据源来衡量自我管理和自我管理支持方面的全国进展情况。
