title: The role of primary care providers in patient activation and engagement in self-management: a cross-sectional analysis.
abstract: BACKGROUND
  The increasing burden of chronic illness highlights the importance of self-care and shifts from hierarchical and patriarchal models to partnerships. Primary care providers (PCPs) play an important role in supporting patients in self-management, enabling activation and supporting chronic care. We explored the extent to which PCPs' beliefs about the importance of the patients' role relate to the frequency in which they report engaging in collaborative and partnership-building behaviors with patients.
  
  
  METHODS
  PCPs' beliefs were measured using the Clinician Support for Patient Activation Measure (CS-PAM). We also assessed whether PCPs' CS-PAM scores were positively associated with changes in their patients' Patient Activation Measure (PAM) scores. Participants included 181 PCPs from a single accountable care organization in Minnesota who completed an online survey. We conducted bivariate analyses and multivariate regression models to examine relationships between CS-PAM and PCP self-management support behaviors and changes in level of patient activation.
  
  
  RESULTS
  PCPs with high CS-PAM scores were much more likely to engage in supportive self-management and patient behavior change approaches, such as involving the patient in agenda-setting, problem-solving, and collaboratively setting behavioral goals, than were PCPs with low CS-PAM scores. More positive PCPs' belief in the patients' role in self-management was positively correlated with improvements in their patients' level of patient activation.
  
  
  CONCLUSIONS
  More positive PCP beliefs about the patients' role in self-management was strongly related to PCP behaviors geared towards increasing patient activation.
authors.affiliation: Department Community-Public Health, Johns Hopkins University School of Nursing, 525 N. Wolfe St, Baltimore, MD, 21201, USA. calvare9@jhu.edu.
authors.forename: Carmen
authors.initials: C
authors.lastname: Alvarez
authors.affiliation: School of Nursing, George Washington University, Washington, DC, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Greene
authors.affiliation: Health Policy Research Group, 1209 University of Oregon, Eugene, Oregon 97403, Eugene, OR, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Hibbard
authors.affiliation: Fairview Medical Group, Minneapolis, Minnesota, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Overton
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010358:Patient Participation; D011320:Primary Health Care / Q000458:organization & administration; D024382:Professional Role; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: Patient activation; Primary care providers; Self-management support