The purpose of this study is to learn if Group Health members who participate in the online chronic disease self-management program will experience improved health outcomes, improved health care utilization, and lower costs.

We will pilot an evidence-based online program for chronic disease self-management that is modeled after the widely-replicated in-person Chronic Disease Self-management Program (CDSMP) developed at Stanford University.

The online CDSMP is an internet-based intervention for people with one or more chronic conditions. It is built on self-efficacy theory and is structured around a formal curriculum that emphasizes problem solving, decision making, and confidence building in weekly sessions over six weeks. The curriculum addresses generic topics and skills that are relevant to managing any chronic condition.

The program is structured around three components: 1) password-protected, interactive web-based instruction; 2) web-based bulletin board discussion groups to enable participatory learning and interaction; 3) and a reference book, Living a Healthy Life with Chronic Conditions, that contains the program content and supplemental information. It is facilitated by two trained lay moderators, at least one of whom has a chronic condition.

Piloting the online CDSMP allows Group Health to learn about and maximize the program's impact in the Group Health system before launching a full-scale program. Since web-based interventions are increasingly recognized as holding promise in health care, our learnings and recommendations will likely be applicable beyond this innovation. The pilot provides GH the opportunity to explore the following about the online CDSMP and web-based tools, in general:

1. Impact of the online CDSMP on participants' psychosocial and health status, health behaviors, and health service utilization
2. Efficient processes for incorporating the online CDSMP into existing operations through use of PDCA cycles
3. An understanding of demographic characteristics of members who are more likely to participate in an online self-management program than an in-person program
4. Effective recruitment and retention strategies
5. Feasibility of sustaining the program without external funding
6. Recommendations for successful implementation of future innovations that utilize web-based media, social networking technology, etc.

Inclusion Criteria:

• Group Health member
• Have access to Group Health enhanced online services
• one or more chronic conditions or a caregiver of someone who fits that criteria
• 18 years of age or older

Exclusion Criteria:

• Not a Group Health member
• No access to Group Health enhanced online services
• No chronic conditions and not a caregiver of someone with a chronic condition
• Under 18 years of age