A Brief Hsitory of Self-Care

A brief history of self-care
(2008-2023)
Self-Care, Health & Wellbeing Summit
Identifying Key Research & Development Priorities for Self-Care
14 Sep 2023
Self-Care Academic Research Unit (SCARU)
a.el-osta@imperial.ac.uk
Austen El-Osta
@austenelosta @ImperialSCARU
Our mission is to ‘make the absolute case for self-care’
2
© Austen El-Osta a.el-osta@imperial.ac.uk
Thought leadership & to be recognized as the academic home of self-care
Democratize access to self-care education & interventions
Making self-care everybody's business
Inverse relationship between
self-care & lifestyle diseases
These risk factors are
modifiable!
[behaviour change]
3
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-management
Self-treatment
Self-efficacy
Self-Care
Empowerment Patient Activation
Refocus on the oldest type of care
139+ different definitions (2011)
“what people do for themselves to establish & maintain health & to
prevent & deal with illness” (WHO 1998)
4
© Austen El-Osta a.el-osta@imperial.ac.uk
Acute conditions
& Trauma
Acute conditions
& Trauma
Healthy
behaviours The Self-Care Continuum
L
J
Self-care & resource utilisation
5
© Austen El-Osta a.el-osta@imperial.ac.uk
The Seven Pillars of Self-Care
knowing
your BMI,
BP etc.
PA at a
desirable
frequency
Make
appropriate
health
decisions
Smoking
cessation
Alcohol
reduction
Seat belt!
Oral/food
hygiene
(& digital!)
Balanced
diet,
5-a-day…
OTC, POM
& community
assets
6
© Austen El-Osta a.el-osta@imperial.ac.uk
1
2
3
4
Person-centred
(daily) activities
Personal choice, empowerment
Behaviours
Capability, motivation, opportunity
Resource utilisation
Spend, reliance on services
Critical enablers
Policies, Laws Regulations,
Community assets, Health System
The Self-Care Matrix
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-care & behaviour change
School Work Retirement
Home
Self-care & behaviour lifestyle modification are a huge area of focus today
But getting people to change behaviour is not easy!
5yr 105yr
Microlearning Interventions
Activation
Incentivization
Nudges
Gamification
Personalisation
8
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-care is not just a mindset, it is an act of will
The ‘self’ is necessarily person-centred
Self-care & person-centredness
Theory Practice Praxis
9
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-care benefits
Self-care can prevent:
• 93% of new-onset T2D
• 81% of heart attacks
• 50% of stroke cases
• 35% of cancers
Can reduce all-cause mortality
Can vastly improve quality of life
Huge social & financial return on
investment potential
Systematic reviews show the positive health behaviours & ongoing self-care activities
can prevent, delay or alter the disease course of NCDs
10
© Austen El-Osta a.el-osta@imperial.ac.uk
2008 2012 2017 2019 2020 2021 2022 2023 2024 2025
|
|
A brief history of self-care
© Austen El-Osta a.el-osta@imperial.ac.uk
2008 2012 2017 2019 2020 2021 2022 2023 2024 2025
|
|
|
|
12
WHO
Resolution
On Self-Care
UK
Self-Care
Strategy
Coalition
A brief history of self-care (2023-2025)
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-Care Megatrends
2000 2030
13
© Austen El-Osta a.el-osta@imperial.ac.uk
Repositioning pharmacies & primary healthcare
as health & wellbeing hubs
Competent HCPs
Self-Gen Data
Places for accessing
self-care tech &
services
14
© Austen El-Osta a.el-osta@imperial.ac.uk
IVD / POCT &
OSC +
eHealth & mHealth
Internet of things & AI
Fitness trackers
Internet pharmacies
Social media platforms
Blood pressure monitor,
Glucometer, Heart rate,
Pedometer
Mood assessment
Movement/fall sensor
Cognitive performance
350,000+
health apps
1000+
wearables
Democratizing access to self-care
Largely consumer focused
(not for patients/NHS) but this is quickly changing
Symptom
checkers
POCT / IVD
Pharmacy / PHC, HCP
focused + @Home
15
© Austen El-Osta a.el-osta@imperial.ac.uk
eHealth & mHealth
Internet of things
Diagnostics
Fitness trackers
Internet pharmacies
Social media platforms
Decision support tools
Artificial intelligence
Blood pressure monitor
Glucometer
Breath-analysis
Heart rate
Pedometer
Mood assessment
Movement/fall sensor
Cognitive performance
350,000+
health apps
1000+
wearables
Largely consumer focused (not for patients) but this is quickly changing
Digital Health Technologies
16
© Austen El-Osta a.el-osta@imperial.ac.uk
The emergence of Society 5.0
SOCIETY
1.0
SOCIETY
2.0
Industrial
SOCIETY
3.0
Electrical
BC… 1760 1879 1983 1997 2000 2019 2030
Steam
engine
Electricity
Hunting Agricultural Industrial
SOCIETY
4.0
Digital
Internet, smartphones
& apps
Information
SOCIETY 5.0
Artificial
intelligence
AI, 3D printing, Drones
Nanotech, Blockchain,
Genetic engineering
Cyberphysical
The wheel
© Austen El-Osta a.el-osta@imperial.ac.uk
“SDH is an umbrella term introduced to conceptualise aspects of healthcare
delivery that can support people in becoming more engaged in their own health
& wellbeing management rather than being passive receivers of healthcare”
Self-Driven Healthcare (SDH)
18
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-Carer
Self-Generated
Data
Personal Health
Record
Physical activity trackers
POCT, IVD & home
monitoring devices
Self-reported mood
tracker
Environmental data
SDH Portal (Horizon 2030)
Interoperable
SDH Portal
Data
sharing options
(including with NHS)
Blockchain secure?
Dashboard view
Personalized risk score
Microlearning to promote
self-care capability
Signposting to relevant
products & services
Personalised
feedback
Actionable insights
to promote the adoption
of health-seeking
self-care behaviours
AI-assisted
clinical coaching 19
© Austen El-Osta a.el-osta@imperial.ac.uk
SDH Horizon 2030
International
Self-Care Day (24/7)
Nov 2023
24 Jul 2023
|
| |
SDH Eco Hub
Business case
2024
SDH
White Paper
|
2027+
SDH portal
20
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-care monitoring & evaluation
21
© Austen El-Osta a.el-osta@imperial.ac.uk
Direct & proxy-measures of self-care
38 instruments
(1957-2022)
5-121 items
Only 5/37 tools
asked questions
about all 7 pillars
22
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-Care CAPability AssessmeNt (CAPITAN)
CAPITAN will provide insights to the self-carer & heath & social care practitioners
Objective measurement / awareness could improve delivery of targeted
interventions to help people become expert self-carers
23
Psychosocial
domain
Digital
literacy
Activation,
etc.,
© Austen El-Osta a.el-osta@imperial.ac.uk
+ + +
Self-Care R&D priorities (2017)
1. Applied research that makes the absolute case for
self-care
2. Development of a pragmatic framework to support
the evaluation of self-care interventions
3. Identification of extant barriers and drivers to the
widespread adoption of evidence-based self-care
praxis
4. Policy research & realignment of incentives to
support self-care initiatives
24
© Austen El-Osta a.el-osta@imperial.ac.uk
2008 2012 2017 2019 2020 2021 2022 2023 2024 2025
|
|
|
|
25
WHO
Resolution
On Self-Care
UK
Self-Care
Strategy
Coalition
A brief history of self-care (2023-2025)
© Austen El-Osta a.el-osta@imperial.ac.uk
Self-Care R&D priorities (2023+)
• Health literacy // Self-Care Literacy (SCL)
• Self-care education (cradle to grave / lifecourse approach & different settings)
• Self-care measurement, monitoring & evaluation
• Policy development (e.g. from HiAP to SCinAP approach?)
• ID barriers & drivers to widespread adoption of self-care interventions
• New reimbursement models (payment by results) & how to realign incentives to
support self-care initiatives
• Etc., etc.,
26
© Austen El-Osta a.el-osta@imperial.ac.uk
• The benefits of self-care are huge - governments & people are taking notice
• Technology is a key enabler of self-care & the emergence of Society 5.0 means
we will have a growing obsession with self-quantification..
• Lifestyle behaviour modification is a huge area of focus today & could be
supported by novel Self-Driven Healthcare approaches
• It is crucial to clarify (the vast!) R&D research priorities for self-care
• This Summit will offer a new point of departure for self-care thinking &
will help guide thought leadership for the next decade
• My special thanks to Jon Adams & The Worldwide Universities Network
for sponsoring this event & for inviting SCARU to host the Summit
Summary
27
© Austen El-Osta a.el-osta@imperial.ac.uk
1 von 27

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A Brief Hsitory of Self-Care

  • 1. A brief history of self-care (2008-2023) Self-Care, Health & Wellbeing Summit Identifying Key Research & Development Priorities for Self-Care 14 Sep 2023 Self-Care Academic Research Unit (SCARU) a.el-osta@imperial.ac.uk Austen El-Osta @austenelosta @ImperialSCARU
  • 2. Our mission is to ‘make the absolute case for self-care’ 2 © Austen El-Osta a.el-osta@imperial.ac.uk Thought leadership & to be recognized as the academic home of self-care Democratize access to self-care education & interventions Making self-care everybody's business
  • 3. Inverse relationship between self-care & lifestyle diseases These risk factors are modifiable! [behaviour change] 3 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 4. Self-management Self-treatment Self-efficacy Self-Care Empowerment Patient Activation Refocus on the oldest type of care 139+ different definitions (2011) “what people do for themselves to establish & maintain health & to prevent & deal with illness” (WHO 1998) 4 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 5. Acute conditions & Trauma Acute conditions & Trauma Healthy behaviours The Self-Care Continuum L J Self-care & resource utilisation 5 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 6. The Seven Pillars of Self-Care knowing your BMI, BP etc. PA at a desirable frequency Make appropriate health decisions Smoking cessation Alcohol reduction Seat belt! Oral/food hygiene (& digital!) Balanced diet, 5-a-day… OTC, POM & community assets 6 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 7. 1 2 3 4 Person-centred (daily) activities Personal choice, empowerment Behaviours Capability, motivation, opportunity Resource utilisation Spend, reliance on services Critical enablers Policies, Laws Regulations, Community assets, Health System The Self-Care Matrix © Austen El-Osta a.el-osta@imperial.ac.uk
  • 8. Self-care & behaviour change School Work Retirement Home Self-care & behaviour lifestyle modification are a huge area of focus today But getting people to change behaviour is not easy! 5yr 105yr Microlearning Interventions Activation Incentivization Nudges Gamification Personalisation 8 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 9. Self-care is not just a mindset, it is an act of will The ‘self’ is necessarily person-centred Self-care & person-centredness Theory Practice Praxis 9 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 10. Self-care benefits Self-care can prevent: • 93% of new-onset T2D • 81% of heart attacks • 50% of stroke cases • 35% of cancers Can reduce all-cause mortality Can vastly improve quality of life Huge social & financial return on investment potential Systematic reviews show the positive health behaviours & ongoing self-care activities can prevent, delay or alter the disease course of NCDs 10 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 11. 2008 2012 2017 2019 2020 2021 2022 2023 2024 2025 | | A brief history of self-care © Austen El-Osta a.el-osta@imperial.ac.uk
  • 12. 2008 2012 2017 2019 2020 2021 2022 2023 2024 2025 | | | | 12 WHO Resolution On Self-Care UK Self-Care Strategy Coalition A brief history of self-care (2023-2025) © Austen El-Osta a.el-osta@imperial.ac.uk
  • 13. Self-Care Megatrends 2000 2030 13 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 14. Repositioning pharmacies & primary healthcare as health & wellbeing hubs Competent HCPs Self-Gen Data Places for accessing self-care tech & services 14 © Austen El-Osta a.el-osta@imperial.ac.uk IVD / POCT & OSC +
  • 15. eHealth & mHealth Internet of things & AI Fitness trackers Internet pharmacies Social media platforms Blood pressure monitor, Glucometer, Heart rate, Pedometer Mood assessment Movement/fall sensor Cognitive performance 350,000+ health apps 1000+ wearables Democratizing access to self-care Largely consumer focused (not for patients/NHS) but this is quickly changing Symptom checkers POCT / IVD Pharmacy / PHC, HCP focused + @Home 15 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 16. eHealth & mHealth Internet of things Diagnostics Fitness trackers Internet pharmacies Social media platforms Decision support tools Artificial intelligence Blood pressure monitor Glucometer Breath-analysis Heart rate Pedometer Mood assessment Movement/fall sensor Cognitive performance 350,000+ health apps 1000+ wearables Largely consumer focused (not for patients) but this is quickly changing Digital Health Technologies 16 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 17. The emergence of Society 5.0 SOCIETY 1.0 SOCIETY 2.0 Industrial SOCIETY 3.0 Electrical BC… 1760 1879 1983 1997 2000 2019 2030 Steam engine Electricity Hunting Agricultural Industrial SOCIETY 4.0 Digital Internet, smartphones & apps Information SOCIETY 5.0 Artificial intelligence AI, 3D printing, Drones Nanotech, Blockchain, Genetic engineering Cyberphysical The wheel © Austen El-Osta a.el-osta@imperial.ac.uk
  • 18. “SDH is an umbrella term introduced to conceptualise aspects of healthcare delivery that can support people in becoming more engaged in their own health & wellbeing management rather than being passive receivers of healthcare” Self-Driven Healthcare (SDH) 18 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 19. Self-Carer Self-Generated Data Personal Health Record Physical activity trackers POCT, IVD & home monitoring devices Self-reported mood tracker Environmental data SDH Portal (Horizon 2030) Interoperable SDH Portal Data sharing options (including with NHS) Blockchain secure? Dashboard view Personalized risk score Microlearning to promote self-care capability Signposting to relevant products & services Personalised feedback Actionable insights to promote the adoption of health-seeking self-care behaviours AI-assisted clinical coaching 19 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 20. SDH Horizon 2030 International Self-Care Day (24/7) Nov 2023 24 Jul 2023 | | | SDH Eco Hub Business case 2024 SDH White Paper | 2027+ SDH portal 20 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 21. Self-care monitoring & evaluation 21 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 22. Direct & proxy-measures of self-care 38 instruments (1957-2022) 5-121 items Only 5/37 tools asked questions about all 7 pillars 22 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 23. Self-Care CAPability AssessmeNt (CAPITAN) CAPITAN will provide insights to the self-carer & heath & social care practitioners Objective measurement / awareness could improve delivery of targeted interventions to help people become expert self-carers 23 Psychosocial domain Digital literacy Activation, etc., © Austen El-Osta a.el-osta@imperial.ac.uk + + +
  • 24. Self-Care R&D priorities (2017) 1. Applied research that makes the absolute case for self-care 2. Development of a pragmatic framework to support the evaluation of self-care interventions 3. Identification of extant barriers and drivers to the widespread adoption of evidence-based self-care praxis 4. Policy research & realignment of incentives to support self-care initiatives 24 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 25. 2008 2012 2017 2019 2020 2021 2022 2023 2024 2025 | | | | 25 WHO Resolution On Self-Care UK Self-Care Strategy Coalition A brief history of self-care (2023-2025) © Austen El-Osta a.el-osta@imperial.ac.uk
  • 26. Self-Care R&D priorities (2023+) • Health literacy // Self-Care Literacy (SCL) • Self-care education (cradle to grave / lifecourse approach & different settings) • Self-care measurement, monitoring & evaluation • Policy development (e.g. from HiAP to SCinAP approach?) • ID barriers & drivers to widespread adoption of self-care interventions • New reimbursement models (payment by results) & how to realign incentives to support self-care initiatives • Etc., etc., 26 © Austen El-Osta a.el-osta@imperial.ac.uk
  • 27. • The benefits of self-care are huge - governments & people are taking notice • Technology is a key enabler of self-care & the emergence of Society 5.0 means we will have a growing obsession with self-quantification.. • Lifestyle behaviour modification is a huge area of focus today & could be supported by novel Self-Driven Healthcare approaches • It is crucial to clarify (the vast!) R&D research priorities for self-care • This Summit will offer a new point of departure for self-care thinking & will help guide thought leadership for the next decade • My special thanks to Jon Adams & The Worldwide Universities Network for sponsoring this event & for inviting SCARU to host the Summit Summary 27 © Austen El-Osta a.el-osta@imperial.ac.uk