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American Recovery and Reinvestment Act
Communities Putting Prevention to Work:
Chronic Disease Self-Management Program

The Purpose of the Program
Background on Chronic Disease Self-Management Programs
Current Activities
Evaluation of Programs
Resources and Useful Links

The Purpose of the Program

Self-management programs provide older adults with education and tools they need to help them cope with chronic diseases such as diabetes, heart disease, lung disease, or arthritis. The programs help participants manage stress, discuss the benefits of physical activity and good nutrition, and help participants communicate more effectively with health care providers. Participants develop action plans related to these topics through structured planning and feedback exercises. Since older adults disproportionately experience chronic diseases, the U.S. Administration on Aging supports the dissemination of self-management programs for chronic diseases by awarding grants to states. State governments then use these funds to develop an infrastructure (workforce, sites, enrollment system) to deliver these programs in communities around the country.

Background on Chronic Disease Self-Management Programs

The Communities Putting Prevention to Work: Chronic Disease Self-Management Program, funded by the American Recovery and Reinvestment Act of 2009, is an initiative led by the U.S. Administration on Aging, in collaboration with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS). This program enables older Americans with chronic diseases to learn how to manage their conditions and take control of their health.

Working together to assure prevention programs are part of the nation’s health and long term care system, state units on aging and the state health departments are full partners in administering the program in each funded state. These agencies work together with their state Medicaid agency and with local agencies on aging, health departments and other local partners to develop a distribution and delivery system that increases the availability of, and access to, these programs, especially low-income, minority and other underserved populations.

The Stanford University Chronic Disease Self-Management Program (CDSMP), which serves as a model for this initiative, teaches consumers skills to manage their conditions and build their self-confidence so they can be successful in adopting healthy behaviors, improve communications with their physician, and enhance their quality of life. The program consists of workshops conducted once a week for two and a half hours over six weeks in community-based settings such as senior centers, congregate meal programs, faith-based organizations, libraries, YMCAs, YWCAs, and senior housing programs. People with different chronic health conditions attend together, and the workshops are facilitated by trained and certified leaders, at least one of whom usually has a chronic illness.

Topics covered include:

  1. Techniques for dealing with problems such as frustration, fatigue, pain and isolation;
  2. Exercise for maintaining and improving strength, flexibility, and endurance;
  3. Nutrition;
  4. Appropriate use of medications, and
  5. Communicating effectively with health professionals.

In addition to the Stanford CDSMP, which is appropriate for anyone with any type of chronic condition, AoA also supports other self-management programs with content specific to diabetes and arthritis. These programs, available in Spanish and 17 other languages, have been proven effective through more than 20 years of research supported by grants from the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention. Statistically significant improvements have been reported in self-efficacy, health behaviors and health status. There is also some evidence of improved health care utilization and reduced health care costs.

The U.S. Administration on Aging, in collaboration with the Centers for Disease Control and Prevention (CDC) awarded $27 million in grants on March 31, 2010. The grants are for a two-year period ending March 30, 2012. To see a list of the grantees and their funding amounts, see the Chronic Disease Self-Management Program State Funding Table at

Current Activities

In 2010, AoA awarded grants to 45 states, Puerto Rico and the District of Columbia to deliver evidence-based self-management programs to older adults with chronic diseases. The purpose of these grant awards is also to build statewide distribution and delivery systems to increase the availability of these programs and provide a distribution channel for other evidence based programs that may be delivered by community based organizations.

As of November 1, 2011, grantees had hosted a total of 6,047 workshops and empowered 50,270 people with the skills and knowledge to better manage their chronic diseases, improve communication with their physician and improve their quality of life. In addition to the English version of the Stanford CDSMP, the Spanish version of CDSMP, English and Spanish versions of Diabetes Self-Management, and English and Spanish version of Arthritis Self-Management were also provided.

Over half of the participants have more than one chronic condition. The most common conditions among the participants are arthritis, high blood pressure, and diabetes. Below is a summary of programs each grantee is providing with contact information if you are interested in participating in a class or interested in learning more about the programs. These summaries provide information on state activities through September 30, 2011. All funded states continue to expand their delivery systems to offer these programs to a broader audience and in more communities.









District of Columbia



















New Hampshire

New Jersey

New Mexico

New York

North Carolina





Puerto Rico

Rhode Island

South Carolina







West Virginia


Evaluation of Programs

During the two-year grant period, Grantees will serve at least 50,000 people and gather evidence regarding the reach and effects of these programs. Two national studies will complement state reporting. Texas A&M Health Science Center and Stanford University Patient Education Research Center will study the effects of the CDSMP on 1000 participants from around the country. In addition, AoA is working with the Centers for Medicare and Medicaid Services (CMS) and the grantees to develop a secure registration system and pilot test the system in one state. The secure registration system will be used to measure the impact of CDSMPs on participant health care utilization and Medicare costs.

Resources and Useful Links