From activated patient to pacified activist: a study of the self-care movement in the United States.

Self-care education programs in operation in the United States during the mid-1980s are surveyed by mailed questionnaire to determine the nature and content of the curricula of these programs, their organizational sponsorship, the level and types of staff working in them, and their principal prevention emphases. Results indicate that over 75% of these programs offer instruction or sponsored activities intended to help individuals or their families to: (1) increase wellness or health status through lifestyle change; (2) reduce an established risk factor; and/or (3) prevent the onset of illness or injury. Fifty-five percent of the organizations offering these services classified themselves as health services delivery organizations. A surprising finding, given the American popular media treatment of self-care as a 'movement', is that relatively few laypersons function as instructors in these programs. The paper describes the way in which self-care has been absorbed into the mainstream of American health care, even though the concept of self-care has tended to drop from scholarly attention in the socio-medical sciences in the United States.