A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians

Shah, Vallabh O.; Carroll, Casey; Mals, Ryan; Ghahate, Donica; Bobelu, Jeanette; Sandy, Phillip; Colleran, Kathleen; Schrader, Ronald M.; Faber, Thomas; Burge, Mark R.

doi:10.1371/journal.pone.0125820

Cited by 35 publications

(70 citation statements)

References 37 publications

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“…Prior interventional studies for chronic disease have had similar outcomes in terms of patient activation. A home-based educational intervention for native Americans with type 2 diabetes by Shah et al 25 found a significant increase in patient activation. Another self-management intervention for diabetic patients in Norwegian primary care demonstrated a persistent increase in their level of activation 26 .…”

Section: Discussionmentioning

confidence: 99%

Activating primary care COPD patients with multi-morbidity through tailored self-management support

Ansari

Hosseinzadeh

Dennis

et al. 2020

npj Prim. Care Respir. Med.

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Given the dearth of COPD self-management interventions that specifically acknowledge multi-morbidity in primary care, we aimed to activate COPD patients through personalised self-management support that recognised the implications of co-morbidities. This single-group experimental study included patients aged 40−84 with a spirometry diagnosis of COPD and at least one co-morbidity. A self-management education programme for COPD in the context of multi-morbidity, based on the Health Belief Model, was tailored and delivered to participants by general practice nurses in face-to-face sessions. At 6 months' follow-up, there was significant improvement in patient activation (p < 0.001), COPD-related quality of life (p = 0.012), COPD knowledge (p < 0.001) and inhaler device technique (p = 0.001), with no significant change in perception of multi-morbidity (p = 0.822) or COPD-related multimorbidity (0.084). The programme improved patients' self-efficacy for their COPD as well as overall health behaviour. The findings form an empirical basis for further testing the programme in a large-scale randomised controlled trial.

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Section: Discussionmentioning

confidence: 99%

Activating primary care COPD patients with multi-morbidity through tailored self-management support

Ansari

Hosseinzadeh

Dennis

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

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“…Moreover the single site study limits results' generalizability. This study design—frequently adopted in research testing the feasibility and potential impact of educational interventions (Hulsman et al, 1999; Berger et al, 2010; Lamiani et al, 2011; Meyer et al, 2011; Bartels et al, 2013; Ledford et al, 2014; Arnold et al, 2015; Shah et al, 2015; Robinson et al, 2016; Viau et al, 2016) is appropriate for the demonstration of feasibility and for initial proof of concept, it is cost effective, and it is pragmatic because it allows for “real world” variability in variables. Consistent with the intent of a pilot study, our goal was to examine feasibility and potential impact.…”

Section: Discussionmentioning

confidence: 99%

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

et al. 2017

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Introduction: Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES.Methods: This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice.Results: Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process.Conclusions: Learning programs teaching nurses about patient engagement strategies and assessment measures in clinical practice are key in supporting the realization of patient engagement in healthcare. Training nurses in this area is feasible and accepted and might have an impact on their ability to engage patients in the chronic care journey. Due to the limitation of the research design, further research is needed to assess the effectiveness of such a program and to verify if the benefits envisaged in this pilot are maintained on a long-term perspective and to test results by employing a randomized control study design.

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“…16 Both education and health literacy are strongly linked to racial disparities and health promotion; 20 however, the association of either of these two factors with patient activation are less well-described. 21–23 …”

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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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A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians

Cited by 35 publications

References 37 publications

Activating primary care COPD patients with multi-morbidity through tailored self-management support

Activating primary care COPD patients with multi-morbidity through tailored self-management support

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

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

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