Living Well with a Disability, a Self-Management Program.

Approximately 56.7 million persons in the United States have functional impairments that can lead to disability. As a group, persons with disabilities show disparities in measures of overall health when compared with the general population. Much of this can be attributed to secondary conditions rather than to the impairment itself. Persons with disabilities can prevent and manage many of the conditions that contribute to these disparities. The Living Well with a Disability program was developed to support persons with disabilities to manage their health. The curriculum helps participants achieve early success in self-management of quality-of-life goals to build confidence for making health behavior changes; it includes 11 chapters that facilitators use to conduct an orientation session and 10 weekly, 2-hour sessions. The program has been implemented by 279 community-based agencies in 46 states. On the basis of the data from the field trial, these community applications have served approximately 8,900 persons since 1995, resulting in an estimated savings of $6.4-$28.8 million for health care payers. Persons with disabilities have unique needs that can be addressed through multiple levels of intervention to reduce health disparities. The Living Well with a Disability program is a promising intervention that has demonstrated improvements in health-related quality of life and health care use.