Empowering Chronic Disease Patients through Self-Management Program: A Mixed-Method Evaluation

Abstract Background Chronic diseases affect over 80% of older adults globally, with 68% having multiple conditions. The Chronic Disease Self-Management Program (CDSMP), introduced in Moldova in 2019 as part of the Healthy Life Project, supported by the Swiss Cooperation Office and implemented by Swiss TPH, aims to empower individuals with chronic conditions to better manage their health. Methods Between March - June 2024, a mixed-methods design was applied in 15 rural communities, involving 204 adult participants with chronic diseases and 30 trained facilitators. Quantitative tools included a 6-item Self-Efficacy Scale (pre-post) and a 10-item Satisfaction Questionnaire. Qualitative data - 15 focus groups with participants and 2 with facilitators. Results The CDSMP evaluation showed meaningful improvements in participants’ health behaviors and self-efficacy, most of them with at least one chronic illness. Self-efficacy scores rose significantly from 4.5 to 8.5, especially in managing fatigue, emotions, and daily routines. 99.2% of participants reported high satisfaction with the program. Facilitators, many living with chronic conditions themselves, offered strong peer support that fostered trust and participant involvement. Focus groups showed that participants felt motivated and supported adopting healthier habits, improved patient-doctor communication, and set personal health goals, and recommended broader implementation of the program to ensure long-term impact. Conclusions The CDSMP demonstrated a strong positive impact on both participants and facilitators, enhancing personal responsibility, encouraging healthier behaviors, and building essential life skills. Participants gained motivation, knowledge, and support to adopt healthier lifestyles, while facilitators experienced meaningful personal and professional growth. The results highlighted the importance of expanding and institutionalizing the program to sustain long-term improvements in chronic disease management. Key messages • Peer-led approaches, like the CDSMP, create trust and shared experience, making self-management education more relatable and effective for people living with chronic illnesses. • Combining quantitative and qualitative evaluation methods provided a deeper understanding of both the measurable outcomes and the lived experiences of participants and facilitators.