Toward consensus on self-management support: the international chronic condition self-management support framework.

Area of Science:

• Health Services Research
• Public Health Policy
• Social Determinants of Health

Background:

• Self-management support (SMS) initiatives often neglect underserved populations, fail to integrate health and social domains, overemphasize individual responsibility, and overlook ethical considerations.
• Existing SMS approaches require enhancement to address systemic gaps and promote health equity.
• A coordinated and comprehensive strategy is needed to guide the development and implementation of effective SMS.

Purpose of the Study:

• To describe a strategic framework for developing comprehensive and coordinated Self-Management Support (SMS) initiatives.
• To provide guidance for decision-makers in planning and implementing SMS at local levels, addressing identified gaps.
• To foster a consensus on advancing the conceptualization, planning, and development of SMS.

Main Methods:

• A multidisciplinary framework was developed collaboratively by researchers, policymakers, practitioners, and consumers from five English-speaking countries.
• The framework underwent review by 203 international participants across 16 countries via an e-survey process.
• The development involved iterative refinement based on expert input and diverse stakeholder perspectives.

Main Results:

• The framework defines self-management (SM) and SMS, presents a collective vision, and outlines eight guiding principles and seven strategic directions.
• It integrates key SM issues into a strategic document designed to inform decision-making for local SMS initiatives.
• The framework promotes system thinking, shared responsibility, health equity, and ethical considerations in SMS development.

Conclusions:

• The developed framework offers a strategic approach to enhance Self-Management Support (SMS) initiatives, particularly for disadvantaged groups.
• It provides a consensus-based guide for planning and implementing SMS that is responsive to local needs and promotes health equity.
• The framework acknowledges the evolving nature of SMS and is intended to be adapted as new evidence and approaches emerge.