title: A qualitative evaluation of patient-perceived benefits and barriers to participation in a telephone care management program.
abstract: OBJECTIVE
  To examine why high-risk individuals targeted for a telephone care management program participated at low rates.
  
  
  METHODS
  Study design consisted of qualitative, semistructured interviews.
  
  
  METHODS
  The setting was a large national insurer's telephone-based care management program. The program employed registered nurses to provide individually tailored education and counseling about health and health care.
  
  
  METHODS
  Study subjects comprised members of a national insurer who were recruited to participate in a care management program but had either dropped out of the program after a short period of initial engagement or had never participated despite recruitment efforts.
  
  
  METHODS
  Interview content was divided into four categories: knowledge of the case management program, barriers to program participation, perceptions of benefits of the program, and suggestions for program improvement.
  
  
  METHODS
  Investigators conducted a directed content analysis.
  
  
  RESULTS
  The most commonly cited barriers to participation were a lack of perceived need and a sense of distrust toward the program and its staff. The most commonly cited benefits were psychosocial support and goal setting.
  
  
  CONCLUSIONS
  Care management programs may benefit from changes to how insurance plan members are selected for the program and from adjusting program content to address perceived needs among members.
authors.forename: Lindsay E
authors.initials: LE
authors.lastname: Jubelt
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
authors.forename: Dana E
authors.initials: DE
authors.lastname: Gatto
authors.forename: Joelle Y
authors.initials: JY
authors.lastname: Friedman
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010346:Patient Care Management / Q000379:methods*; D015397:Program Evaluation; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D055815:Young Adult
keywords: Care Coordination; Chronic Disease; Disease Management; Health Behavior; Patient Care Management; Patient-Centered Care; Prevention Research. Manuscript format: research; Research purpose: descriptive; Study design: qualitative; Outcome measure: patient-reported themes; Setting: national; Health focus: chronic disease management; and weight control; Strategy: education and skill building/behavior change; Target population age: adults; including fitness/physical activity; stress management