title: An environmental scan of policies in support of chronic disease self-management in Canada.
abstract: BACKGROUND
  The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives.
  
  
  METHODS
  This descriptive study was conducted as an environmental scan, consisting of an Internet search of government and other publicly available websites, and interviews with jurisdictional representatives identified through the Health Council of Canada and academic networking.
  
  
  RESULTS
  We interviewed 16 representatives from all provinces and territories in Canada and found 30 publicly available and relevant provincial and national documents. Most provinces and territories have policies that incorporate aspects of chronic disease self-management. Alberta and British Columbia have the most detailed policies. Both feature primary care prominently and are not disease specific. Both also have provincial level implementation of chronic disease self-management programming. Canada's northern territories all lacked specific policies supporting chronic disease self-management despite a significant burden of disease.
  
  
  CONCLUSIONS
  Engaging patients in self-management of their chronic diseases is important and effective. Although most provinces and territories have policies that incorporate aspects of chronic disease self-management, they were often embedded within other initiatives and/or policy documents framed around specific diseases or populations. This approach could limit the potential reach and effect of self-management.
authors.affiliation: Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre, Ottawa, Ontario, Canada; University of Ottawa, Department of Family Medicine, Ottawa, Ontario, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Liddy
authors.affiliation: Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre, Ottawa, Ontario, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Mill
mesh_terms: D000416:Alberta; D001955:British Columbia; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration; D011050:Policy Making; D011320:Primary Health Care / Q000458:organization & administration*; D012648:Self Care
keywords: chronic disease self-management; environmental scan; health policy; primary care; self-management support