Self regulation of chronic disease Noreen Clark Center for Managing Chronic Disease University of Michigan

1. Self-Regulation in Chronic Disease Noreen M. Clark, Ph.D. March 23, 2002

5. Management by Patient Family Involvement Clinical Expertise Work/School Support Community Awareness, Support & Action Community-Wide Environmental Control Measures Conducive Policies

9. Patient efforts to manage asthma and heart disease serve as the context for studying self-regulation.

12. A Model of Self-Regulation

29. Stable elements of Self-Regulation Baseline .175 (.000) Intrapersonal Factors External Factors Management Strategies Judgment Observations Confidence .021 (.026) .015 (.042) .535 (.000) .357 (.000)

30. Stable elements of Self-Regulation Follow-up 1 .184 (.000) Intrapersonal Factors External Factors Management Strategies Judgment Observations Confidence .299 (.000) .061 (.000) .399 (.003) .464 (.000)

31. Stable elements of Self-Regulation Follow-up 2 .126 (.000) Intrapersonal Factors External Factors Management Strategies Judgment Observations Confidence .191 (.000) .251 (.000) .447 (.000) . 624 (.000)

32. Elements of Self-Regulation .126 (.000) .184 (.000) .175 (.000) Baseline Follow -up 1 Follow -up 2 Intrapersonal Factors Intrapersonal Factors Intrapersonal Factors External Factors Management Strategies Judgment Judgment Observations Confidence Observations Observations Confidence & Outcome Expectations .021 (.026) .535 (.000) .299 (.000) .399 (.003) .191 (.004) .447 (.000) . 251 . 624 (.018) (.000) .161 (.000) . 464 (.000) .015 (.042) . 357 (.000) External Factors External Factors Management Strategies Management Strategies Confidence & Outcome Expectations Judgment

33. Predictive Ability of Constructs

35. Tentative Conclusions

41. Specific Techniques May Enhance Self-Regulation Skills