Dartmouth-Hitchcock staff organize and facilitate delivery of the Stanford Chronic Disease Self-Management program, an evidence-based learnign course that helps patients learn tools and become more confident and assertive in engaging in self-care needed to live successfully with chronic health conditions like diabetes and high blood pressure.  People who participate more regularly in this program see increased health benefits; this marker is an indicator of how well Dartmouth-Hitchcock's staff  are at engaging patients to maintain pariticpation in the program, a proxy for how many patients will realize helath benefits from this work.