Please include R coding for each response Chronic conditionsarediseases thatlastoneyearormoreandrequireongoing medicalattention,such as diabetes and cancer.The growing number of patients with chronic conditions has significanteconomic implications; according to the Centers for Disease Control, diabetes costs the United States health care system and employers $237 billion annually.

Astrategyforreducingtheburdenonhealthcaresystemsispromotingpatient self-management, in which patients proactively take action to maintain and improve their own health. For patientswith a chronic condition, daily maintenance constitutes a form of prevention that can lead to betterqualityoflifeandreduce healthcarecosts. Inindividualswithdiabetes,forinstances,adhering to recommended diet and exercise regimens can help reduce the risk of serious complications likeheartdiseaseorstroke.

Self-management is not appropriate for all patients. A study was conducted among 1,154 adult patients from different regions in the Netherlands to identify characteristics associated with activationforself-management.Studyparticipantshadaclinical diagnosisofoneoffourchronicconditions: Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF), Diabetes MellitusTypeII(DM-II),orChronicRenalDisease(CRD).

The primary outcome, activation for self-management, was assessed with the Patient ActivationMeasure (PAM-13),a questionnaire which assesses self-reported knowledge, skills, and confidence forself-management. ScoreonthePAM-13rangesfrom0to100,withahigherscoreindicatinga higher levelofself-managementactivation. Scorescanbeclassifiedintooneoffourlevels: Level1 (47.0points),Level2(47.155.1points),Level3(55.267points),andLevel4(67.1points).A Level1patientdemonstrateslackofknowledge andconfidencetomanagetheircondition.ALevel 2 patient demonstrates a limited amount of knowledge and ability to set goals. Both Level 1 and Level2patients typicallybelievethattheirhealth islargelyoutoftheir controlandareconsidered passive recipients of care. In contrast, a Level 3 patient is goal-oriented and actively working to achievebestpracticebehaviors. ALevel4patienthassuccessfullymaintainednewbehaviorovertime.

InadditiontothePAM-13,participantscompletedassessmentsmeasuringhealthstatus,anxietyand depression, and perceived social support.

• HealthStatus.HigherscoresontheShortForm-12HealthSurvey(SF-12)areindicativeofbetter health status; possible scores range from 0-100 points.The survey consists of twosummary scores on the 0-100 scale, one measuring physical health and one measuring mentalhealth.
• Anxiety andDepression. Higher scores on the Hospital Anxiety and Depression Scale (HADS)indicatesahigherstateofanxietyordepression.Scoresrangefrom0-21pointsforeachcomponent, and a score of 11 or greater suggests the presence of an anxiety or depressivedisorder.
• SocialSupport.HigherscoresontheMultidimensionalScaleofPerceivedSupport(MSPSS) indicateshigherperceivedsupport,suchasfromfamily,friends,andsignificantothers. Scoresrangefrom0-84points.

Information was also collected on participant sociodemographics, such as level of financial distressandeducationallevel.Educationallevelwasdividedintolower(primaryschoolthroughvocationaltraining), middle (secondary school), and high (college or university) education, according to theDutchschoolsystem.

Datafromthestudyareinthefileself_manage.Rdata.Thefollowingtableprovidesalistofthevariables in the dataset and their descriptions. (table 1, variable/description)