Response to a Patient Activation Intervention among Spanish-speaking Patients at a Community Health Center in New York City

Maranda, Michael; Deen, Darwin; Elshafey, Suzanne; Herrera, Milton M.; Gold, Marthe R.

doi:10.1353/hpu.2014.0110

Cited by 20 publications

(19 citation statements)

References 25 publications

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“…The significance of the potential measure differences between the P-PAM and PAM are most salient when considering the relation between activation and healthcare outcomes. Interventions to increase activation among immigrant Latino adults have resulted in increased comfort with asking questions of providers and increased care retention [28,29]. Similar associations between health and healthcare outcomes and P-PAM score would suggest that activation as measured by the P-PAM may still be a useful intervention target in pediatrics despite the measure limitations identified in this study, but this is not yet known.…”

Section: Discussionmentioning

confidence: 77%

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

DeCamp

Leifheit

Shah

et al. 2016

Patient Education and Counseling

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Objective (1) To measure healthcare activation among low-income parents by language (English/Spanish); and (2) to assess the psychometrics of the Parent-Patient Activation Measure (P-PAM) in the study population. Methods We surveyed parents/guardians of publicly-insured children who were established patients at a pediatrics clinic for ≥6 months. Surveys included the Parent-Patient Activation Measure (P-PAM), a 13-item measure adapted from the well-validated Patient Activation Measure (PAM). Results Of 316 surveys, 68% were completed in Spanish. Mean activation score in the English-language survey group was 79.1 (SD 16.2); mean score in the Spanish-language group was 70.7 (SD 17.9) (p < 0.001). Scale reliability was high (English α = 0.90; Spanish α = 0.93). The P-PAM had acceptable test-retest reliability, but no previously reported PAM factor structure fit the study data adequately for either language. Conclusions Healthcare activation among low-income parents was greater for parents surveyed in English compared with those surveyed in Spanish. The P-PAM has acceptable reliability and validity in English and Spanish, but a different factor structure than the PAM. Practice implications Activation as measured by the P-PAM may not have the same associations with or impact on health/healthcare outcomes in pediatrics compared with adults owing to possible measure differences between the P-PAM and PAM.

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Section: Discussionmentioning

confidence: 77%

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

DeCamp

Leifheit

Shah

et al. 2016

Patient Education and Counseling

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“…Out of 87 included studies, the term, sex was mentioned in 37 (42.5%) studies [ 54 – 58 , 60 – 64 , 66 , 68 , 70 , 71 , 79 , 83 , 85 , 87 , 89 , 95 , 96 , 98 , 103 , 105 , 107 , 110 , 112 , 114 , 119 – 122 , 126 , 128 , 130 – 132 ]. Gender was mentioned in 36 (41.4%) studies [ 51 , 52 , 58 , 60 , 61 , 63 , 65 , 70 , 71 , 77 , 82 , 87 , 89 , 91 , 96 – 99 , 101 , 104 , 106 , 112 , 114 , 117 – 119 , 121 , 124 , 125 , ...…”

Section: Resultsmentioning

confidence: 99%

Sex and gender considerations in implementation interventions to promote shared decision making: A secondary analysis of a Cochrane systematic review

Adisso

Zomahoun²,

Gogovor³

2020

PLoS ONE

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Background Shared decision making (SDM) in healthcare is an approach in which health professionals support patients in making decisions based on best evidence and their values and preferences. Considering sex and gender in SDM research is necessary to produce precisely-targeted interventions, improve evidence quality and redress health inequities. A first step is correct use of terms. We therefore assessed sex and gender terminology in SDM intervention studies.

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“…Studies have found that patient education and empowerment efforts, such as the Stanford Chronic Disease Self-Management Program and coaching with motivational interviewing, increase activation. [23][24][25][26][27][28][29][30][31] Very little research, however, has examined the clinician role in supporting patient activation. Given clinicians' key potential impact on patient behavior, this is an important area for investigation.…”

Section: Introductionmentioning

confidence: 99%

Supporting Patient Behavior Change: Approaches Used by Primary Care Clinicians Whose Patients Have an Increase in Activation Levels

et al. 2016

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PURPOSE We aimed to identify the strategies used to support patient behavior change by clinicians whose patients had an increase in patient activation.METHODS This mixed methods study was conducted in collaboration with Fairview Health Services, a Pioneer Accountable Care Organization. We aggregated data on the change in patient activation measure (PAM) score for 7,144 patients to the primary care clinician level. We conducted in-depth interviews with 10 clinicians whose patients' score increases were among the highest and 10 whose patients' score changes were among the lowest. Transcripts of the interviews were analyzed to identify key strategies that differentiated the clinicians whose patients had top PAM change scores. RESULTSClinicians whose patients had relatively large activation increases reported using 5 key strategies to support patient behavior change (mean = 3.9 strategies): emphasizing patient ownership; partnering with patients; identifying small steps; scheduling frequent follow-up visits to cheer successes, problem solve, or both; and showing caring and concern for patients. Clinicians whose patients had lesser change in activation were far less likely to describe using these approaches (mean = 1.3 strategies). Most clinicians, regardless of group, reported developing their own approach to support patient behavior change. Those whose patients showed high activation change reported spending more time with patients on counseling and education than did those whose patients showed less improvement in activation.CONCLUSIONS Clinicians vary in the strategies they use to promote behavior change and in the time spent with patients on such activities. The 5 key strategies used by clinicians with high patient activation change are promising approaches to supporting patient behavior change that should be tested in a larger sample of clinicians to validate their effectiveness. 2016;14:148-154. doi:10.1370/afm.1904. Ann Fam Med INTRODUCTIONT hrough policies such as pay for performance and public reporting of clinicians' quality of care, clinicians are increasingly responsible for their patients' care outcomes. [1][2][3][4] Yet, for health outcomes to improve, patients must do their part, following through on treatment regimens and making recommended lifestyle changes.5-7 Given the key role that patients play in determining health outcomes, policy makers have made patient engagement and patient activation a major focus, including embedding approaches for increasing engagement in the Patient Protection and Affordable Care Act. 8,9 Patient activation, which is defined as having the knowledge, confidence, and skills to take care of one's health and health care, has been shown to be associated with a broad range of health-related outcomes, including better self-management and clinical indicators, fewer hospitalizations, and lower health care costs. [10][11][12][13][14][15][16][17][18][19][20] [34][35][36] Also, patients' assessment of clinician support of the chronic care model has been associated with hig...

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Response to a Patient Activation Intervention among Spanish-speaking Patients at a Community Health Center in New York City

Cited by 20 publications

References 25 publications

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

Cross-cultural validation of the parent-patient activation measure in low income Spanish- and English-speaking parents

Sex and gender considerations in implementation interventions to promote shared decision making: A secondary analysis of a Cochrane systematic review

Supporting Patient Behavior Change: Approaches Used by Primary Care Clinicians Whose Patients Have an Increase in Activation Levels

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