Building Healthier Communities: Value Co-Creation within the Chronic Care Model for Rural Under-Resourced Areas

Chronic disease is a worldwide epidemic that disproportionately affects low- to middle-income countries and regions [1]. The Chronic Care Model (CCM) is intended to address the significant societal costs and health burdens of chronic disease through redesign of the health care system and has raised awareness of the need for integration of clinical services and public health resources. To complement this descriptive, a-theoretical framework, we develop a theory-driven research model rooted in service-dominant logic (S-D logic). Our model conceptualizes improved chronic disease health outcomes as cocreated value and focuses on triadic actor-to-actor-to actor (patients, family/friends and health care providers) resource integration and service exchange. We illustrate the model's utility for policy and intervention design and for research on diabetes self-management programs in low-income, rural communities, in which patients' social capital resources can be integrated with health IT and healthcare expertise in CCM program design.