NH Chronic Disease Self-Management Network
Stanford Chronic Disease Self- Management Program
Better Choices, Better Health, Leader Training Application Form
The New Hampshire Chronic Disease Self-Management Network is offering a Leader Training for “Better
Choices, Better Health,” the Stanford Chronic Disease Self-Management Program (CDSMP) primarily targeting
adults over 60 and their caregivers. The 4 day training will prepare you to lead workshops for consumers.
Consumer workshops run for 2 ½ hours per week for 6 weeks. As part of the training, leaders will receive
training materials, a leader’s relaxation CD, as well as a participant textbook.
Who:
We are turning to community leaders, such as yourself, to help us identify potential trainers so that we may
develop a sustainable program for members of our community with chronic diseases.
What:
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CDSMP is an evidence-based program and is endorsed by the Administration on Aging (AoA), Center
for Disease Control and Prevention (CDC), and the National Council on Aging (NCOA).
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The nationally recognized CDSMP was developed and researched by Stanford University and is a lay-led
participant education program offered in communities in the United States and several other countries.
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The program provides information and teaches practical skills on managing chronic health problems.
The CDSMP gives people the confidence and motivation they need to manage the challenges of living
with a chronic health condition.
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The Self-Management Program will not conflict with existing programs or treatment. It is designed to
enhance regular treatment and disease-specific education such as Better Breathers, cardiac
rehabilitation, or diabetes instruction.
For more information on the Stanford Chronic Disease Self-Management Program (CDSMP),
please refer to http://patienteducation.stanford.edu/programs/cdsmp.html.
Where and When: Thursday September 27, Friday September 28, Monday October 1st and Tuesday
October 2, 2012
- Breathe New Hampshire’s New Office Space
- 145 Hollis Street, Unit C, Manchester, NH
Considerations:
Each “Better Choices, Better Health” workshop held in the community must be led by two trained Leaders.
Stanford recommends that Leaders be individuals living with a chronic condition, and that at least one of the
two Leaders be a peer Leader and not a health or social service provider.
Typical Leaders will be able to…
- commit to offering at least one 6-week program within one year, preferably within three months of
being trained.
- support promotion and implementation of the program, using organizational support or resources from
the NH CDSMP Network.
- ensure that either Northern or Southern NH AHEC receives follow-up information about workshops and
participants on a regular basis, using forms provided by the NH CDSMP Network.
- reach diverse audiences including low income and high-risk populations.
- understand that leaders will be operating under a license from Stanford University (that has been paid
for through 2012). Please contact SNH AHEC with any questions regarding the license at (603) 8951514 ext 1.
Revised 1/11/2011
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Better Choices, Better Health
Leader Training Application Form
Applicant Information (please duplicate this page as needed)
Name of Leader applicant: ______________________________________________
Address: ____________________________________________________________
Phone: _________________________ Email: _______________________________
Will you be a Lay Leader (non health/social service professional)? Yes No
Are you living with a chronic condition? Yes No
Have you attended a Better Choices, Better Health program as a participant? Yes No
Sponsoring Agency: ________________________________________
(not required)
Title/Position: __________________________________________________________
Applicant Signature ________________________________________Date__________
______________________________________________________________________
Title
Do you need any special accommodations at this training?
(please specify): ________________________________________________________
CONTACT INFORMATION for trainings held in the counties of:
Cheshire, Sullivan, Merrimack, Hillsborough, Rockingham and Strafford
Tracie Holmes
Southern NH AHEC
128 State Route 27
Raymond, NH 03077
Fax: 603-895-1312
tholmes@snhahec.org
Phone: (603) 895-1514 ext. 4
Revised 1/11/2011
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