Edwin B. Fisher ^1*, Carol A. Brownson ¹, Mary L. O'Toole ¹, Gowri Shetty ¹, Victoria V. Anwuri ¹, Russell E. Glasgow ²

¹ Washington University
² Kaiser Permanente Colorado

^* To whom correspondence should be addressed. E-mail: efisher{at}im.wustl.edu.

	Abstract

In the Diabetes Initiative of The Robert Wood Johnson Foundation, an ecological was used to identify the following key resources and supports for self-management (RSSM): individualized assessment, collaborative goal setting, skills enhancement, follow-up and support, access to resources, and continuity of quality clinical care. These RSSM reflect the grounding of diabetes self-management in the context of social and environmental influences. Research supports the value of each of these key resources and supports. Differences among self-management interventions may be seen as complementary, rather than conflicting, ways of addressing RSSM. This way of understanding differences among interventions may aid development of varied programs to reach diverse audiences. In contrast to the "5 A's" model of key provider services (Assess, Advise, Agree, Assist, and Arrange), RSSM articulate self-management from the perspective of individuals' needs. Both approaches emphasize identification of goals, teaching of skills, and facilitation and reinforcement of the use of those skills. (Am J Public Health. 2005;95:1523-1535. doi:10.2105/AJPH.2005.066084)

Key Words: Diabetes, Chronic Disease, Community Health, Health Education, Health Promotion

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