Patient Commitment to Health (PACT-Health) in the Heart Failure Population: A Focus Group Study of an Active Communication Framework for Patient-Centered Health Behavior Change

Abstract

Background Over 6 million Americans have heart failure, and 1 in 8 deaths included heart failure as a contributing cause in 2016. Lifestyle changes and adherence to diet and exercise regimens are important in limiting disease progression. Health coaching and public commitment are two interactive communication strategies that may improve self-management of heart failure. Objective This study aimed to conduct patient focus groups to gain insight into how best to implement health coaching and public commitment strategies within the heart failure population. Methods Focus groups were conducted in two locations. We studied 2 patients in Oakland, California, and 5 patients in Los Angeles, California. Patients were referred by local cardiologists and had to have a diagnosis of chronic heart failure. We used a semistructured interview tool to explore several patient-centered themes including medication adherence, exercise habits, dietary habits, goals, accountability, and rewards. We coded focus group data using the a priori coding criteria for these domains. Results Medication adherence barriers included regimen complexity, forgetfulness, and difficulty coping with side effects. Participants reported that they receive little instruction from care providers on appropriate exercise and dietary habits. They also reported personal and social obstacles to achieving these objectives. Participants were in favor of structured goal setting, use of online social networks, and financial rewards as a means of promoting health lifestyles. Peers were viewed as better motivating agents than family members. Conclusions An active communication framework involving dissemination of diet- and exercise-related health information, structured goal setting, peer accountability, and financial rewards appears promising in the management of heart failure.

A Hospital-Community-Family–Based Telehealth Program for Patients With Chronic Heart Failure: Single-Arm, Prospective Feasibility Study

“…Emerging evidence suggests that telehealth interventions may improve self-care behaviors and disease management for elderly patients [11,31,32]. The Web-based social networks acting as an active communication framework can be an effective means of promoting healthy lifestyles [33]. In the study, patients were encouraged to document their conditions and medicine use and then received personalized health coaching tailored for their individual situation through face-to-face communications, which can intensify the patient’s health behaviors, medication adherence, and self-management ability.…”

The Hospital-Community-Family–Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study (Preprint)

“…In general, it is currently well recognized that lifestyle and risk factors modification for atrial fibrillation should be managed as chronic diseases requiring multiple repeated interventions to bring forth long-term successful outcomes. Telemedicine contributing to lifestyle improvement has been confirmed in other domains of medicine [50][51][52][53][54][55][56]. On the one hand, telemedicine provides patients and their caregivers with sustaining education on the necessity of lifestyle alterations [50,57].…”

Intervensi Health Coaching dalam Meningkatkan Self-Care Management Pasien Heart Failure

“…Dari 5 artikel yang disintesis, didapatkan 3 artikel menggunakan telepon yang membahas self-care management, kualitas hidup, hasil klinis dan status kesehatan pasien HF, menerima perawatan biasa, health coaching, dan booklet tentang HF sebagai panduan dan materi (Dwinger et al, 2020;Tiede et al, 2017;Wang et al, 2017), 1 artikel menggunakan metode diskusi dengan tatap muka langsung yang mengulas selfcare management pasien dengan menggunakan teknik wawancara semi terstruktur dengan pertanyaan terbuka yang berfokus pada pasien (Meeker et al, 2019). Artikel lain menggunakan kombinasi telepon dan tatap muka yang membahas perawatan diri pasien dengan pendekatan motivational interviewing (Vellone et al, 2020).…”