Assessing activation stage and employing a "next steps" approach to supporting patient self-management.

Current approaches to chronic illness care seek to engage the patient as part of the care team. Yet, finding effective ways to engage patients in their own care and support patient self-management has been challenging. Instead of pushing patients to immediately adopt all recommended behavioral changes, many programs encourage small steps while working toward a larger goal. A strategy that first assessed the level of mastery, and then encouraged "next step" behaviors, may be more effective as the recommended steps would be calibrated to the patient's level of competency. In this analysis, we build on the previous research to determine whether there are behaviors that are more or less likely to be adopted at different stages of activation.