Introducing the chronic disease self-management program in Switzerland and other German-speaking countries: Findings of a cross-border adaptation using a multiple-methods approach

Jörg Haslbeck, Sylvie Zanoni, Uwe Hartung, Margot Klein, Edith Gabriel, Manuela Eicher, Peter J. Schulz

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29 Scopus citations


Background: Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process. Methods: Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G). Results: Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization. Conclusions: Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.

Original languageEnglish
Article number576
JournalBMC Health Services Research
Issue number1
StatePublished - 28 Dec 2015

Bibliographical note

Funding Information:
2Since 2015, there have been new efforts to deliver CDSMP workshops in Germany, which are not part of the study at-hand. The program «Living healthy and actively» is disseminated by the multi-stakeholder consortium INSEA (accronym stands for «Initiative für Selbstmanagement/Selbsthilfe, Empowerment und Aktiv Leben»; English Translation: «Initiative for Self-Management/Self-help, Empowerment and Active Living»). It currently consists of a regional self-help organization (Selbsthilfekontaktstelle Bayern, Germany) and the first mini-med school in Germany (Patient University, Hannover), which are delivering the workshops and are supported by two non-profit foundations (Robert Bosch Foundation, Germany; Careum Foundation, Switzerland) and a health insurance fund (Barmer GEK, Germany). Unlike the unsuccsessful 1st attempt in Germany, the two organisations now delivering the workshops have sustainable field access at their disposal and additional funding at hand. For

Publisher Copyright:
© 2015 Haslbeck et al.


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