Guiding Principles for Chronic Disease Management for Vulnerable and Disadvantaged People: Pilot Study Findings

Background: The need for chronic disease self-management (CDS-M) is increasing worldwide. CDS-M programs are variably effective for vulnerable and disadvantaged individuals. Objectives: The objects of this study were 1) To explore experiences of health workers leading CDS-M programs for vulnerable and disadvantaged populations, and 2) To develop guiding principles for the delivery of more effective CDS-M programs for vulnerable and disadvantaged populations. Methods: Two focus groups were undertaken, with all primary health workers, and allied health (AH) staff in a large community centre in an Australian city, who worked with vulnerable and disadvantaged individuals with chronic disease. Results: Consistent messages were identified, producing nine guiding principles. Self-management programs / messages should be tailored to cultural groups, learning styles and available supports, cultural sensitivities, group leadership requirements, language, literacy levels, belief systems and social circumstances and supports, past experiences, and individuals’ ability to motivate change. Implications: The draft guiding principles may assist others to deliver more effective CDS-M programs for disadvantaged and vulnerable populations. BACKGROUND Chronic disease (CD) poses an enormous challenge to Australian health and social systems. 1 CD in Australia now contributes to over 70% of the burden of disease, and is expected to increase to 80% by 2020.2 In response, the Australian Government has initiated a major focus on CD prevention and management through three complementary policies: the National Chronic Disease Strategy, National Service Improvement Framework, and the Blueprint for Chronic Disease Surveillance.3 This has been supported by increased government funding for CD self-manageme nt (S-M) programs delivered by primary health services across Australia.4 The priority CDs outlined under the National Service Improvement Framework are asthma, cancer, diabetes, heart disease, stroke and vascular disease, osteoarthritis, rheumatoid arthritis, and osteoporosis. 3