Chronic Disease Self-Management Program Logging
Program Description
 


Developed by the Chronic Disease Self-Management Program of Stanford University Patient Education Research Center, the Chronic Disease Self-Management Program is a 2 1/2-hour workshop conducted once a week for six weeks. Sessions are led by trained peer leaders and/or master trainers, at least one of whom has a chronic health condition or provides care to someone with a chronic condition.


Trained facilitators teach the skills needed in the date-to-day management of chronic conditions to maintain and/or increase life activities.

Contact Information
Application Date:
First Name:
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Last Name:
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Address:
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Address 2:
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Are you currently a certified CDSMP Leader?  

Do you have a chronic health condition?  
If Yes, Please List/Describe:

Are you a caregiver for someone with a health condition?  
If Yes, Please Specify:



What qualities do you feel you possess that would make you a good CDSMP Master Trainer/Leader?


 
Leader and Master Trainer Agreement

You will be certified to teach the CDSMP course after meeting these requirements.

  • Attended all 4 days of Lay Leader training or 4 ½ days of Master Leader training.
  • Be associated with an entity licensed by Stanford University Patient Education Research Center to provide the CDSMP.
  • Commit to teach the CDSMP as developed by the Stanford University Patient Education Research Center, as outlined in the Leader Manual.
  • Follow recommendations from Lay Leader Trainers or T-Trainers, based on your demonstrated practice teaching.

If selected as a Kentucky leader, I agree to the following requirements.

  • Co-teach two entire 6-week Chronic Disease Self-Management Programs in association with the Kentucky Department for Aging & Independent Living and the Kentucky Department for Public Health twice a year within the next two consecutive years.
  • Complete and submit necessary documentation of classes taught.



Coordinate all CDSME Lay-Leader Trainings with the Department for Aging & Independent Living (DAIL) as DAIL holds the CDSME License. Failure to coordinate with DAIL will jeopardize your teaching status.


The fee for this training is waived if two classes are taught within one year of the date of training. Reasonable cost associated with participation in the training will be provided by the Department for Aging & Independent Living.


You may only train other CDSMP Leaders after attending CDSMP Master Training Course and teaching at least two 6-week courses with another leader.


Leaders and Master Trainers are not employees of Stanford University, the Kentucky State Department for Public Health or Kentucky Department for Aging & Independent Living. The organization that employs you may compensate you for teaching the course.




I will attend all 4 days of Lay Leader Training or 4 ½ days of the Master Leader Training. I agree to co-teach two entire 6-week Chronic Disease Self-Management Programs in association with an entity licensed by Stanford University within 12 months of this training. In association with the Kentucky Department for Public Health & The Kentucky Department for Aging & Independent Living, I shall provide the CDSMP course within my community twice a year within the next two consecutive years. I will teach in strict accordance with the program as written in the Leaders Manual and as taught to me as a Lay Leader or Master Leader Training.


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