An Ecological Approach to Self-Management (MT UCEDD)

September 17, 2013

Dr. Craig Ravesloot

When provided in the usual medical service delivery context, self-management training has been called self-management support (SMS). Adding rural to the service delivery context adds a layer of complexity as healthcare management resources are often scarce or difficult to access in rural America, particularly for people with disabilities. Dr. Craig Ravesloot, Director of Rural Health Research at the University of Montana Rural Institute on Disabilities RTC: Rural, tested an ecological health intervention that blended independent living (IL) philosophy and self-management support techniques to facilitate health management among people with disabilities living within the rural service delivery context. The intervention guided consumers to further develop self-advocacy skills in consumer choice and control by using Personal Community Resource Mapping (PCRM) to search for, locate, and access existing health and community resources that support their personal health management needs.

The research project compared results of this ecological health intervention with a standard health education program based on a modification of the RTC: Rural's Living Well with a Disability (LWD) health promotion program. Research results showed that consumers who advocated support from rural community service providers had longer term maintenance of positive health behavior change and reduction of secondary conditions compared to the modified LWD program, which did not include PCRM. As such, promoting efficient use of existing health resources as a self-management support approach provides promise for rural residents living with disabilities. RTC: Rural continues to examine ecological approaches to address the health of people living with disabilities by focusing on the context and impact of rural community. Please visit http://rtc.ruralinstitute.umt.edu/_rtcBlog/?page_id=5111 for project reports and practice recommendations.