Implementing Self-Management Support In Primary Care: New Multi-Media Resources

Background: Self-management support (SMS) is increasingly recognized as a fundamental strategy to help patients manage their chronic conditions, reduce service utilization and improve quality of care. Federal agencies, foundations, advocacy organizations, and medical associations all have undertaken national initiatives to advance SMS.  With so many materials and projects sponsored by a variety of health care organizations, it is difficult for providers to know where to turn for resources on how to implement SMS in their practices. 

Program background: In response to this need, the Agency for Healthcare Research and Quality’s (AHRQ) Prevention/Care Management Portfolio (P/CM) developed two SMS resources for primary care clinician teams: 1) a one-stop, searchable multi-media library of action-oriented educational materials, accompanied by 2) three brief, motivational videos that illuminate SMS skills and concepts.AHRQ promotes the use of evidence-based research to improve the quality of care for all Americans.   Just as the Agency reviews and synthesizes the clinical evidence regarding treatment for busy front line clinicians, it has created an evidence-base on specific SMS initiatives.  To help communicate SMS concepts contained in the library, AHRQ created video vignettes of practitioners utilizing SMS techniques.

Evaluation Methods and Results: Initial methods to develop the resource library included an environmental scan of public websites with a known focus on self-management and SMS interventions and a PubMed literature review.  A technical expert panel (TEP) reviewed the draft library. Furthermore, the TEP recommended video vignettes to draw clinicians to the library and further explain SMS methods. Videotaping occurred in five geographically diverse clinical practices that varied in size and specialty. The videos were user-tested with 11 primary care clinicians and revised based on feedback. AHRQ’s SMS resource library contains 46 multi-media materials from 21 sources such as resource guides, articles, toolkits, videos, tip sheets, or tools which clinicians can use with their patients. The TEP discussed how clinicians are at different stages of adopting SMS methods and need to access resources appropriate to their level of understanding and knowledge.  Consequently, the library was organized according to “what” is SMS, “why” is SMS important? and “how” can SMS be implemented?  At the TEP’s suggestion, AHRQ developed three companion videos intended to inspire clinicians to utilize the SMS resource library. Feedback from clinicians during video user-testing revealed that one of the videos was not pertinent for small and solo practices, and it was revised. 

Conclusions: AHRQ’s multi-media resource library is intended to further communicate and disseminate SMS techniques, and the videos seek to inspire clinicians to adopt these techniques in practice.  As the field of SMS matures, new tools and new knowledge can be incorporated into AHRQ’s resource library. 

Implications for research and/or practice: AHRQ’s multi-media resource library offers a robust set of SMS tools as well as companion videos that help health care teams in small and large practices visualize and adopt SMS techniques in practice.  However, further evaluation of the effectiveness of SMS tools and techniques is needed.