Taking the Long View

Hibbard, Judith H.; Greene, Jessica; Shi, Yunfeng; Mittler, Jessica; Scanlon, Dennis P.

doi:10.1177/1077558715573871

Cited by 130 publications

(72 citation statements)

References 28 publications

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“…These findings conflict with previous studies’ findings that whites were more likely to have high levels of patient activation. 8,37 …”

Section: Resultsmentioning

confidence: 99%

“…Previous research suggests that patient activation is a modifiable and important factor for determining chronic disease outcomes. 37 The participants in this study are part of a well-defined cohort that is taking part in a policy-relevant study, which will evaluate healthcare utilization. 25 Our current study may help clinicians approach patient activation conversations with older adults with functional difficulties.…”

Section: Resultsmentioning

confidence: 99%

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Factors associated with patient activation in an older adult population with functional difficulties

Gleason

Tanner

Boyd

et al. 2016

Patient Education and Counseling

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Objective Patient activation, the patient’s knowledge, skill, and confidence to manage his or her health, is an important indicator of future health and use of health care resources. Understanding factors associated with patient activation in an older population with functional difficulties may inform care in this population. This study aimed to determine whether patient activation is associated with depression, chronic conditions, family support, difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), hospitalizations, education, and financial strain. Methods (N=277), We administered surveys measuring patient activation, financial strain, depressive symptoms, family support, and chronic conditions to an older adult population. We tested association through multivariate linear regressions controlling for race, sex, and age. Results Patient activation is significantly (p<0.05), positively associated with family support and self-rated overall health, and significantly (p<0.05), negatively associated with depressive symptoms and difficulties with ADLs and IADLs. We found no association between patient activation and financial stress, hospitalizations, and education. Conclusions Older age, depressive symptoms, and difficulties with ADLs and IADLs were associated with decreased patient activation. Practice Implications Developing interventions tailored to older adults’ level of patient activation has the potential to improve outcomes for this population.

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“…These findings conflict with previous studies’ findings that whites were more likely to have high levels of patient activation. 8,37 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors associated with patient activation in an older adult population with functional difficulties

Gleason

Tanner

Boyd

et al. 2016

Patient Education and Counseling

View full text Add to dashboard Cite

show abstract

“…35 Again of 3 to 5 points is associated with improved health behaviors and positive health outcomes. 36 …”

Section: Methodsmentioning

confidence: 99%

Examination of the Effects of an Intervention Aiming to Link Patients Receiving Addiction Treatment With Health Care

Weisner

Felicia

et al. 2016

JAMA Psychiatry

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IMPORTANCE Research has shown that higher activation and engagement with health care is associated with better self-management. To our knowledge, the linkage intervention (LINKAGE) is the first to engage patients receiving addiction treatment with health care using the electronic health record and a patient activation approach. OBJECTIVE To examine the effects of an intervention aiming to link patients receiving addiction treatment with health care. DESIGN, SETTING, AND PARTICIPANTS A nonrandomized clinical trial evaluating the LINKAGE intervention vs usual care by applying an alternating 3-month off-and-on design over 30 months. Participants were recruited from an outpatient addiction treatment clinic in a large health system between April 7, 2011, and October 2, 2013. INTERVENTIONS Six group-based, manual-guided sessions on patient engagement in health care and the use of health information technology resources in the electronic health record, as well as facilitated communication with physicians, vs usual care. MAIN OUTCOMES AND MEASURES Primary outcomes, measured at 6 months after enrollment, were patient activation (by interview using the Patient Activation Measure), patient engagement in health care (by interview and electronic health record), and alcohol, drug, and depression outcomes (by interview using the Addiction Severity Index for alcohol and drug outcomes and Patient Health Questionnaire (PHQ) for depression). RESULTS A total of 503 patients were recruited and assigned to the LINKAGE (n = 252) or usual care (n = 251) conditions, with no differences in baseline characteristics between conditions. The mean (SD) age of the patients was 42.5 (11.8) years, 31.0% (n = 156) were female, and 455 (90.5%) completed the 6-month interview. Compared with usual care participants, LINKAGE participants showed an increase in the mean number of log-in days (incidence rate ratio, 1.53; 95% CI, 1.19–1.97; P = .001). Similar results were found across types of patient portal use (communicating by email, viewing laboratory test results and information, and obtaining medical advice). LINKAGE participants were more likely to talk with their physicians about addiction problems (odds ratio, 2.30; 95% CI, 1.52–3.49; P < .001). Although 6-month abstinence rates were high for both conditions (≥70.0% for both) and depression symptoms improved (the proportion with scores≥15 on the 9-item PHQ dropped from 15.1% [38 of 252] to 8.0% [18 of 225] among LINKAGE participants), there were no differences between conditions. Those who received all intervention components had significantly better alcohol and other drug outcomes than those who received fewer intervention components. CONCLUSIONS AND RELEVANCE Findings support the feasibility and effectiveness of the LINKAGE intervention in helping patients receiving addiction treatment engage in health care and increase communication with their physicians. The intervention did not affect short-term abstinence or depression outcomes. Understanding if the LINKAGE intervention helps ...

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“…5–7 Furthermore, increases in patient activation scores over time have been correlated with improvements in medication adherence, self-management knowledge, health behaviors, and functional health. 8 Accordingly, it is important to foster environments where patients can successfully take an active role in their care to improve their health. 9 …”

mentioning

confidence: 99%

Health Literacy and Education as Mediators of Racial Disparities in Patient Activation Within an Elderly Patient Cohort

Eneanya¹,

Winter²,

Cabral³

et al. 2016

Journal of Health Care for the Poor and Underserved

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The Patient Activation Measure (PAM) assesses facets of patient engagement to identify proactive health behaviors and is an important predictor of health outcomes. Health literacy and education are also important for patient participation and successful navigation of the health care system. Because health literacy, education and patient activation are associated with racial disparities, we sought to investigate whether health literacy and education would mediate racial differences in patient activation. Participants were 265 older adults who participated in a computer-based exercise interventional study. Health literacy was assessed using the Test of Functional Health Literacy in Adults (TOFHLA). Of 210 eligible participants, 72% self-identified as Black and 28% as White. In adjusted analyses, education and health literacy each significantly reduced racial differences in patient activation. These findings are especially important when considering emerging data on the significance of patient activation and new strategies to increase patient engagement.

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Taking the Long View

Cited by 130 publications

References 28 publications

Factors associated with patient activation in an older adult population with functional difficulties

Factors associated with patient activation in an older adult population with functional difficulties

Examination of the Effects of an Intervention Aiming to Link Patients Receiving Addiction Treatment With Health Care

Health Literacy and Education as Mediators of Racial Disparities in Patient Activation Within an Elderly Patient Cohort

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