The effect of patient choice of intervention on health outcomes

Clark, Noreen M.; Janz, Nancy K.; Dodge, Julia A.; Mosca, Lori; Lin, Xihong; Long, Qi; Little, Roderick J. A.; Wheeler, John R. C.; Keteyian, Steven J.; Liang, Jersey

doi:10.1016/j.cct.2008.04.002

Cited by 45 publications

(44 citation statements)

References 25 publications

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“…When the patients' choice and self-evaluation are incorporated, positive treatment effects on motivation, participation, and functional recovery have been found in different patient populations and clinical settings [17][18][19]. Preferably, individualized measures sensitive to varying needs and situations should be included in pain rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Canadian Occupational Performance Measure performance scale: Validity and responsiveness in chronic pain

et al. 2014

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Abstract-The construct validity and construct responsiveness of the performance scale of the Canadian Occupational Performance Measure (COPM) was measured in 87 newly admitted patients with chronic pain attending an outpatient rehabilitation clinic. At admission and after 12 wk, patients completed a COPM interview, the Pain Disability Index (PDI), and the RAND 36-Item Health Survey (RAND-36). We determined the construct validity of the COPM by correlations between the COPM performance scale (COPM-P), the PDI, and the RAND-36 at admission. Construct responsiveness was assessed by calculating the correlations between the change scores (n = 57). The COPM-P did not significantly correlate with the PDI (r = 0.260) or with any subscale of the RAND-36 (r = 0.007 to 0.248). Only a moderate correlation was found between change scores of the COPM-P and PDI (r = 0.380) and weak to moderate correlations were found between change scores of the COPM-P and the RAND-36 (r = 0.031 to 0.388), with the higher correlations for the physical functioning, social functioning, and role limitations (physical) subscales. In patients with chronic pain attending our rehabilitation program, the COPM-P measures something different than the RAND-36 or PDI. Therefore, construct validity of the COPM-P was not confirmed by our data. We were not able to find support for the COPM-P to detect changes in occupational performance.

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Section: Introductionmentioning

confidence: 99%

Canadian Occupational Performance Measure performance scale: Validity and responsiveness in chronic pain

et al. 2014

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“…Prior publications provide additional details on study design and outcomes of this trial. [16][17][18] All participants were community-dwelling women 60 years of age treated by daily heart medication for a cardiovascular condition (i.e., arrhythmia, angina, myocardial infarction [MI], congestive heart failure [CHF], or valvular disease). Names of potential study participants were generated from patient rosters at clinics in three urban areas in Michigan.…”

Section: Methodsmentioning

confidence: 99%

Progression of Symptoms and Functioning Among Female Cardiac Patients With and Without Diabetes

Janevic

Janz

Connell

et al. 2011

Journal of Women's Health

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Objective: To determine if older women with both heart disease and diabetes experience worse physical and psychosocial functioning and higher symptom burden over an 18-month period compared with those with heart disease alone. Methods: Data from older women with heart disease (60 years, n ¼ 1008, 18% with diabetes) were used to assess the impact of diabetes on physical functioning (Sickness Impact Profile [SIP]-Physical and Six-Minute Walk test [6MWT]), psychosocial functioning (SIP-Psychosocial and depressive symptoms), and physical symptom burden (cardiac and general) at baseline and 4, 12, and 18 months later. Generalized estimating equation models compared trends in outcomes over time between groups with and without diabetes. Results: Across all four time points, women with heart disease and diabetes had greater functional impairment, as indicated by higher SIP scores, than those without diabetes (43%-71% higher SIP-Physical scores and 32%-65% higher SIP-Pyschosocial scores; all p 0.002). 6MWT distance was 17%-30% less in the diabetes group across time points (all p 0.002). Depressive symptoms were 27%-39% higher in the diabetes group (all p < 0.03) except at month 4. Women with diabetes scored 15%-29% higher on a physical symptom index across time points (all p < 0.05) than those without diabetes; no significant differences were observed in cardiac symptoms until month 18 (diabetes group 29% higher, p ¼ 0.02). Subgroups with and without diabetes in this sample experienced significantly different trends over time in SIP-Physical scores ( p ¼ 0.02) and 6MWT distance ( p ¼ 0.05), such that the disadvantage of the diabetes group at baseline was greater 18 months later. Conclusions: Women with comorbid diabetes and heart disease are vulnerable to poor health-related quality of life, particularly in terms of physical functioning and symptoms, and require special efforts from clinical care providers to ameliorate a potential downward trend in these outcomes over time.

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“…Her research program evaluating individual-level interventions for managing chronic disease employed rigorous and complex designs, including randomized controlled designs (take PRIDE; Clark et al, 1997), preference designs (Clark et al, 2008), and those integrating qualitative and quantitative methodologies (Janz, Clark, & Dodge, 2002). In this issue, in the article titled "Declines With Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations," published shortly after her death, Noreen and her team used mixed effects models with mixture distributions to demonstrate the need to adjust for natural declines in symptoms and health care use with age of children in order to determine true intervention effects when a control group is not possible.…”

Section: Managing Chronic Disease: Individuals At the Center Of Solutmentioning

confidence: 99%

The Life and Career of Noreen M. Clark

et al. 2014

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Noreen M. Clark's career as practitioner and professor of health behavior and health education spanned many years in the field, and her extensive writings on management of chronic disease, self-regulation, physician care education, and translation and dissemination have greatly contributed to the shift in emphasis from medical solutions to self-management of chronic illness. Noreen often pointed out that over half of the population worldwide lives with at least one chronic disease, and that most everyone will be touched either directly or indirectly by the effects of a chronic illness. The financial and human costs of chronic disease are tremendous.Noreen also noted that Americans have a tendency to medicalize health-related problems, and to depend on physicians and drugs to solve them, even though in many instances this has not been an effective approach (Clark, 2009). Researchers and practitioners have made numerous calls for enhancing capacity to increase the critical role that individuals and their families play in the management of chronic disease, and the need for our health systems to educate and support individuals (and their families) to manage their disease on their own (Clark, 2009). Noreen clearly voiced the need to shift our focus to self-management programs if we want to have a major effect on improving quality of life, reducing unnecessary health care use, and cutting health care expenditures (Clark, 2009). In addition, Noreen's influence extended beyond the United States and spanned other topics such as addressing social determinants of health through community and coalition approaches worldwide.This tribute issue contains eight selected publications written by Noreen and her colleagues over the 31-year period from 1982 to 2013 to represent some of the key areas of her work. The purpose of compiling this collection of her writings is both to honor her legacy and to bring attention to the influence of Noreen's work on the field of public health and health care. We hope this compilation will make available to present and future generations of health educators the theoretical principles, self-management perspective, and focus on vulnerable populations that Noreen so strongly advocated and advanced. We recognize that one volume alone, however, cannot capture adequately the extensive reach she has had on the theory, research, and practice of health education.

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The effect of patient choice of intervention on health outcomes

Abstract: Background-Patient preference may influence intervention effects, but has not been extensively studied. Randomized controlled design (N=1075) assessed outcomes when women (60 years +) were given a choice of two formats of a program to enhance heart disease management.

Cited by 45 publications

References 25 publications

Canadian Occupational Performance Measure performance scale: Validity and responsiveness in chronic pain

Canadian Occupational Performance Measure performance scale: Validity and responsiveness in chronic pain

Progression of Symptoms and Functioning Among Female Cardiac Patients With and Without Diabetes

The Life and Career of Noreen M. Clark

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