title: The role of patient activation in improving blood pressure outcomes in Black patients receiving home care.
abstract: Variations in patients' self-management knowledge, skills, and confidence as measured by the Patient Activation Measure (PAM) have been linked to variations in health behavior and outcomes. In a randomized trial, we tested two blood pressure (BP) control interventions, one grounded in activation principles. Study participants were Black home care patients (N = 587) with uncontrolled hypertension. This article examines intervention impacts on 12-month PAM score change, other predictors of PAM change, and associations between PAM change and BP outcomes. In multivariate models, the interventions did not significantly affect PAM change. Baseline characteristics associated with increased PAM were lower PAM score, higher income, higher health literacy, younger age, lower systolic BP, diabetes, and fewer medications. PAM increase was associated with a modest reduction in diastolic BP but not with improved systolic BP or BP control. Although studies suggest that increasing activation may lead to improved patient outcomes, this study did not find it to be so.
authors.affiliation: 1Visiting Nurse Service of New York, NY, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Ryvicker
authors.forename: Penny Hollander
authors.initials: PH
authors.lastname: Feldman
authors.forename: Ya-Lin
authors.initials: YL
authors.lastname: Chiu
authors.forename: Linda M
authors.initials: LM
authors.lastname: Gerber
mesh_terms: D001741:Black or African American; D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006699:Home Care Services; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D012648:Self Care; D016896:Treatment Outcome
keywords: African Americans; hypertension; patient activation; self-management