Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks—medical management, role management, and emotional management—and six self-management skills—problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems.

Self-management education: history, definition, outcomes, and mechanisms.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60735-1.pdf

Correlates of physical activity: why are some people physically active and others not?

http://www.ced.berkeley.edu/downloads/research/LUP.parks.pdf

Urban green space, public health, and environmental justice: The challenge of making cities ‘just green enough’

https://www.rug.nl/staff/e.m.steg/abrahamsestegvlekrothengatterreview.pdf

A review of intervention studies aimed at household energy conservation

Although there is a large and growing literature on tailored print health behavior change interventions, it is currently not known if or to what extent tailoring works. The current study provides a meta-analytic review of this literature, with a primary focus on the effects of tailoring. A comprehensive search strategy yielded 57 studies that met inclusion criteria. Those studies-which contained a cumulative N = 58,454-were subsequently meta-analyzed. The sample size-weighted mean effect size of the effects of tailoring on health behavior change was found to be r = .074. Variables that were found to significantly moderate the effect included (a) type of comparison condition, (b) health behavior, (c) type of participant population (both type of recruitment and country of sample), (d) type of print material, (e) number of intervention contacts, (f) length of follow-up, (g) number and type of theoretical concepts tailored on, and (h) whether demographics and/or behavior were tailored on. Implications of these results are discussed and future directions for research on tailored health messages and interventions are offered.

/pdf/does-tailoring-matter-meta-analytic-review-of-tailored-print-xsem787pqh.pdf

Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions.

Objectives. This study examined (1) descriptive patterns in perceived environmental and policy determinants of physical activity and (2) associations between these factors and behavior. Methods. A cross-sectional study was conducted from 1999 to 2000 among US adults; individuals at lower income levels were oversampled. Results. Availability of areas for physical activity was generally higher among men than among women. The 4 most commonly reported personal barriers were lack of time, feeling too tired, obtaining enough exercise at one's job, and no motivation to exercise. Neighborhood characteristics, including the presence of sidewalks, enjoyable scenery, heavy traffic, and hills, were positively associated with physical activity. There was a high level of support for health policy–related measures. Up to one third of individuals who had used environmental supports reported an increase in physical activity. Conclusions. An array of environmental and policy determinants, particularly those related to the ...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.91.12.1995

Environmental and Policy Determinants of Physical Activity in the United States

Through the use of new technologies researchers and practitioners in health education and health communication can now provide health information and behavior change strategies that are customized based on the unique needs interests and concerns of different individuals. These are examples of tailored health messages which can be highly effective in assisting individuals in understanding and responding to health concerns. This book discusses the process of tailoring and its use in health communication programs. Moreover it presents a theoretical and public health rationale for tailoring and supports its position with empirical evidence. It is noted that tailored health promotion messages are any combination of information and behavior change strategies intended to reach one specific person based on characteristics that are unique to that person related to the outcome of interest and derived from an individual assessment. Hence it measures a participants needs interests and concerns and uses that information to create health messages and materials to fit that person. The step-by-step approach in creating tailoring programs is described in this book.

Tailoring Health Messages: Customizing Communication With Computer Technology

Purpose: To understand the relationships between street-scale environments and rates of physical activity, it is crucial to develop reliable methods of measurement. Community audits are commonly used to test the walkability and bikability of environments, yet few have been tested for reliability. Methods: Audit tools were collected from the peer-reviewed literature, the Internet, and experts from a variety of backgrounds. Two versions of an audit instrument were created: an “analytic” (with Likert-scale and ordinal-response choices) and a “checklist” (with dichotomous response choices) audit tool. Audits were conducted in St Louis, MO for 147 street segments, representing both higher and lower income neighborhoods. The same segments were re-audited to assess interrater reliability. Results: Characteristics of the physical environment varied considerably across lower and higher income segments. For example, in the checklist audit, physical disorder was present for 67 segments in lower income segments, compared with 0 segments in higher income segments. Among 8 questions from each audit tool designed to broadly capture environmental attributes, most had moderate to poor agreement. Most of the transportation and land-use items demonstrated high (substantial or perfect) agreement, and the aesthetics and social environment items showed reliability in the moderate to fair range. Conclusions: A community audit tool can be relatively easy and quick to administer and, for many domains, is reliable. Our audit tools appear particularly well suited for capturing elements in the transportation and land-use environments.

Reliability of 2 Instruments for Auditing the Environment for Physical Activity

The growing emphasis on promoting environmental change as a means to increase physical activity has motivated conversation and collaboration between researchers and practitioners in the fields of public health and urban planning. Although these fields share similar objectives, their methodological approaches for examining the association between the environment and behavior often differ in significant ways. To facilitate communication, this article discusses ways these fields can collaborate in developing and applying conceptual frameworks, adopting behavioral and environmental measures, and strengthening study designs. By collaborating to build synergism in research and dissemination, public health and urban planning professionals can enhance efforts to increase the number of communities that promote active living.

Opportunities for integrating public health and urban planning approaches to promote active community environments.

The childhood obesity epidemic has stimulated the emergence of many policy and environmental strategies to increase healthy eating and active living, with relatively few research recommendations identifying the most effective and generalizable strategies. Yet, local, state, and national decision makers have an urgent need to take action, particularly with respect to lower-income and racial and ethnic populations at greatest risk. With the surge of promising and emerging policy and environmental strategies, this review provides a framework, criteria, and process modeled from existing expert classification systems to assess the strength of evidence for these strategies. Likewise, this review highlights evidence gaps and ways to increase the types and amount of evidence available to inform policy and environmental strategies. These priorities include documenting independent and interdependent effects, determining applicability to different populations and settings, assessing implementation fidelity and feasibility, identifying cumulative benefits and costs, ascertaining impacts on health equity, and tracking sustainability.

https://www.annualreviews.org/doi/pdf/10.1146/annurev-publhealth-031210-101206

Accelerating Evidence Reviews and Broadening Evidence Standards to Identify Effective, Promising, and Emerging Policy and Environmental Strategies for Prevention of Childhood Obesity

Laura K. Brennan

Papers

Environmental and Policy Determinants of Physical Activity in the United States

Tailoring Health Messages: Customizing Communication With Computer Technology

Reliability of 2 Instruments for Auditing the Environment for Physical Activity

Opportunities for integrating public health and urban planning approaches to promote active community environments.

Accelerating Evidence Reviews and Broadening Evidence Standards to Identify Effective, Promising, and Emerging Policy and Environmental Strategies for Prevention of Childhood Obesity