New Jersey Uses AHRQ Network to Create Chronic Care Self-Management Program

Prevention and Care Management
March 2009

A team of local and state organizations from New Jersey participated in AHRQ's 2007-2008 Evidence-Based Disability and Disease Prevention for the Elders Learning Network. During the course of the Elders Learning Network, the program trained nine peer leaders to lead the AHRQ-funded Chronic Disease Self-Management Program (CDSMP) classes, recruited physicians to promote the program among their peers, and refined the model that now operates in 16 counties.

The Elders Learning Network was comprised of teams from six states—Illinois, Maine, Maryland, Massachusetts, New Jersey, and Ohio. AHRQ formed the Elders Learning Network to disseminate AHRQ findings from evidence-based models, to support knowledge transfer from experts about the use of evidence-based interventions for clinical and community-based prevention, and to encourage teams to share lessons learned from their experience operating their program. Working with state aging and health agencies, the team developed a model for state-wide implementation.

Led by Mary Lou Schnurr, Director of the Sussex County Division of Senior Services in New Jersey, the coalition of community organizations implemented a CDSMP by building linkages with clinical providers. The team included the director of RSVP, a community action agency; the clinical manager of health education from Newton Memorial Hospital; and representatives from state aging, health, and Medicaid agencies. The team collaborated to solicit support from clinical providers, recruit peer leaders, and identify sites to host the CDSMP activities. Presentations were also made by team members to groups of physicians at local hospitals. A "prescription pad" was designed for physicians to refer patients to the CDSMP.

"Participating in AHRQ's Elder Learning Network is the reason we have a Chronic Disease Self-Management Program in Sussex County," says Schnurr. "The time spent with experts and other states having experience operating these programs helped us design the program and understand the importance of identifying 'physician champions' to build support."

Impact Case Study Identifier: 
AHRQ Product(s): Elders Learning Network
Topics(s): Chronic Care: Self-Management
Geographic Location: New Jersey
Implementer: State of New Jersey
Date: 03/01/2009

Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Ritter PL, Gonzalez VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial. Medical Care 37(1):5-14, 1999. (HSO6680)

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