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Online Chronic Disease Self-Management Program

The Online Chronic Disease Self-Management Program is a six-week workshop offered on a dedicated web site. The workshop does not require “real time” attendance (i.e., there are bulletin boards rather than chat rooms). Trained peer facilitators work in pairs to moderate each workshop. Each week, participants are asked to log on at least three times for a total of about two hours. Weekly activities include reading and interacting via the Learning Centre, making and posting a weekly action plan, participating in problem solving and guided exercises on bulletin boards, and participating in any appropriate self-tests and activities. Participants are encouraged to post chronic disease-related problems on a bulletin board and help other group members with their problems. A workshop is formed when there are enough people expressing interest to fill a workshop (about 25 people). At least one of the two facilitators has a chronic condition. The facilitators do not teach content; rather, they see that participants log on to weekly learning modules and discussion areas, and send them emails if this does not happen. They also monitor discussion boards daily.

The program includes the following topics:
  • how to develop a suitable exercise program;
  • cognitive symptom management;
  • healthy eating;
  • breathing exercises;
  • problem solving;
  • communication skills with family, friends and health care providers;
  • use of medication;
  • and how to deal with emotions of chronic illness (anger and depression).
Each participant in the workshop is mailed a copy of the companion book, Living a Healthy Life With Chronic Conditions, 3rd Edition. It is the process in which the program is taught that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives. As in other self-management workshops, the Online Chronic Disease Self-Management Program will not conflict with existing programs or treatment. It is designed to enhance regular treatment and disease-specific education such as cardiac rehabilitation or diabetes instruction. In addition, many people have more than one chronic condition. The program is especially helpful for these people, as it gives them the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives.

Course participants include persons living with chronic health conditions, as well as their family, friends and caregivers. It has been designed so that it can be used by almost anyone who has access to the Internet, including those that do not have access to broadband.

Program participants are self-referred and potential participants express interest through an online registration process. Recruitment strategies include a website and toll-free line, brochures, flyers, and posters, newspaper and television advertisements, and presentations to the public.

Program Manuals
The Online Chronic Disease Self-Management Program follow a protocol (Facilitator’s Manual) that provides detailed guidelines for the conduct of the program.
Fidelity Standards for Training and Implementation
A contract is developed and licensees are obligated to deliver the program in the specified manner with no modifications or additions. Mentors are responsible for the day-to-day support and oversight of the facilitators. They ensure that facilitators prepare for workshops by completing model action plans and problem postings. They review activity within the workshop for appropriateness and safety, providing feedback to facilitators if necessary. They delete inappropriate postings and remove problem participants from the workshops. They support the facilitators in resolving situations in which they are unfamiliar or uncomfortable. The evidence-based self management programs previously offered by the Stanford Patient Education Research Center have moved to the Self-Management Resource Center. In 2016, the SMRC published a “Program Fidelity Manual” and “Administration/Implementation Manual” for trainers and administrators. The program is copyrighted by the Self-Management Resource Center (SMRC) and each organization wishing to implement the Online Chronic Disease Self-Management Program applies and purchases a license from SMRC. A contract is developed and licensees are obligated to deliver the program in the specified manner with no modifications or additions. For more information, please visit the SMRC website at

Program’s Evaluation History
  • Lorig, K, Ritter PL, Plant K, Laurent DD. The South Australian Health Chronic Disease Self-Management internet trial. Health Educ & Beh. 2012. doi:10.1177/1090198112436969
  • Jernigan VB, Lorig K. An internet diabetes self-management workshop for American Indians and Alaska Natives. Health Promotion Practice, Epub ahead of print, July 2010.
  • Case SM, Jernigan VBBJ, Gardner AL, Ritter PL, Heaney CA, Lorig KR. Content and Frequency of Writing on Diabetes Bulletin Boards: Does Race Make a Difference? Journal of Medical Internet Research, 11(2):e22, 2009.
  • Lorig KR, Ritter PL, Dost A, Plant K, Laurent DD, McNeil I. The expert patients programme online, a 1-year study of an Internet-based self-management programme for people with long-term conditions. Chronic Illness, 4(4): 247-256, 2008.
  • Lorig KR, Ritter PL, Laurent DD, Plant K. Internet-Based Chronic Disease Self-Management: A Randomized Trial. Medical Care, 44(11), 964-71, 2006.