Innovation in primary care has increased interest in patient self-management techniques; little is known about the methods practices use to support self-management. This study is a survey of small practices, fewer than 5 physicians, with NCQA (National Committee for Quality Assurance) recognition (response rate 59.1%). Main measures include the number and delegation of self-management support activities. Practices reported a high proportion of self-management support activities. Physicians perform most of these activities. Practices that reported receiving training in self-management were more likely to have high self-management support to delegate. Self-management support activities are performed mainly by physicians. Practices that perform more of these activities have more nonindependent health care providers.