Research Priority: Health Behaviors to Prevent and Manage Chronic Conditions

Prevention and management of chronic conditions is a national goal for improved population health. Programs that support positive health behaviors and decrease risk behaviors are needed to improve health outcomes.

  • Chronic conditions are those health issues that last longer than 1 year, require regular medical care, and limit activities of daily living.2 
  • Chronic disease is the leading cause of disability and is estimated to account for over 85% of U.S. health care costs. Approximately 1 in 2 adults have at least one chronic condition. Heart disease, stroke, cancer, diabetes, obesity, and arthritis are among the most common chronic diseases.3
  • The Centers for Medicare and Medicaid Services (CMS) tracks utilization and costs for 19 chronic conditions. Over two thirds of beneficiaries have more than one chronic condition. Multiple chronic conditions contribute significantly to functional limitations and health care costs
  • Improving positive health behaviors and eliminating health risk behaviors are central to prevention and management of chronic disease.2
  • Data gathering and prevention programs at both the individual and population level are needed to track trends and progress, develop healthy environments, design health care system interventions, and connect clinical and community services.4
  • Self-management and chronic disease management programs are needed to address the symptoms of chronic conditions, increase confidence in skills, and improve quality of life.5


Urgent Need

Prevention and management of chronic conditions has been identified as:


  • a critical issue for promoting health and well-being for many conditions and populations
  • an area in which evidence-based measures and interventions are needed
  • an area where application of the unique expertise of occupational therapy would be highly beneficial

  

The OT Lens

Health behaviors may be defined as the “doing of everyday activities” that support wellbeing, including medication management, exercise, and healthy eating. Occupational therapy research seeks to understand the preventative and protective function of daily activities in promoting and maintaining health. Prevention of chronic conditions requires adoption and maintenance of daily habits and routines that promote health.  Making changes in health behaviors requires strategies that address both biomedical and sociocultural factors. Effective management of chronic conditions requires knowledge of how symptoms influence the ability to perform everyday activities and the habits, routines, and environmental supports that may be used to maintain health and quality of life.  6

Opportunity to Affect Progress

There are a few occupational therapy scientists who are building knowledge related to health behaviors and chronic conditions.  However, there is no coordinated network for occupational therapy research in this area, nor sufficient resources to train more occupational therapy researchers.  We believe a significant investment is needed to improve health behaviors for the prevention and management of chronic conditions in order to achieve better outcomes and improve quality of life.


1. Healthy People  http://www.healthypeople.gov/2020/about/foundation-health-measures/General-Health-Status 


2. Centers for Medicare and Medicaid Services. (2015). Chronic disease. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/CC_Main.html
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Downloads/2012Chartbook.pdf 


3. Centers for Disease Control and Prevention. (2016). Chronic disease prevention and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/index.htm 


4. Centers for Disease Control and Prevention. (2015). The four domains of chronic disease prevention. Retrieved from 

http://www.cdc.gov/chronicdisease/pdf/four-domains-factsheet-2015.pdf 

http://www.ncbi.nlm.nih.gov/pubmed/24996589 


5. Centers for Disease Control and Prevention. (2015). Chronic disease self-management programs. Retrieved from  http://www.cdc.gov/arthritis/marketing-support/1-2-3-approach/docs/pdf/provider_fact_sheet_overview.pdf 


6. Hand, C. L., Letts, L. J., & von Zweck, C. M. (2011). An agenda for occupational therapy's contribution to collaborative chronic disease research. Canadian Journal of Occupational Therapy78(3), 147-155.

 

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