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Can J Public Health. 2012 Nov 6;103(6):e462-7.

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

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Department of Family medicine, University of Ottawa, ON.



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.


Self-care; chronic disease; program evaluation; self-management support

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