Building the evidence base for chronic disease self-management support interventions across Canada.

Abstract

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. 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. 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. 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.