"PHE in Action": Development and Modeling of an Intervention to Improve Patient Engagement among Older Adults.
The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization ofPHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning).PHEinActionis the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups engage in effective health management and informs future trials.
Department of Psychology, Catholic University of the Sacred Heart Milan, Italy.
Julia
J
Menichetti
Department of Psychology, Catholic University of the Sacred Heart Milan, Italy.
Guendalina
G
Graffigna
chronic disease; intervention development; older patients; patient activation; patient engagement
J Ambul Care Manage. 2012 Apr-Jun;35(2):80-9
22415281
J Abnorm Psychol. 1986 Aug;95(3):274-81
3745650
J Am Med Inform Assoc. 2016 Jan;23(1):159-65
26078412
J Card Fail. 2013 Sep;19(9):647-54
24054342
Public Health Rep. 2004 May-Jun;119(3):239-43
15158102
J Cardiovasc Nurs. 2006 May-Jun;21(3):232-41
16699364
J Med Internet Res. 2015 May 28;17(5):e132
26022846
Patient Educ Couns. 2005 Jul;58(1):27-34
15950833
Schizophr Res. 2010 May;118(1-3):264-70
20185272
Lancet. 2015 Feb 7;385(9967):563-75
25468158
Can J Aging. 2010 Mar;29(1):11-21
20202262
Health Aff (Millwood). 2013 Feb;32(2):207-14
23381511
J Med Internet Res. 2012 Jun 25;14(3):e63
22732765
Patient Educ Couns. 2011 Aug;84(2):257-60
20800414
Int J Psychiatry Med. 2002;32(1):37-53
12075915
Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26
15230939
Lancet Psychiatry. 2015 Jan;2(1):38-48
26359611
Disabil Rehabil. 2015;37(12):1073-81
25163832
Patient Educ Couns. 2016 May;99(5):760-8
26682971
Health Aff (Millwood). 2013 Feb;32(2):223-31
23381514
Health Aff (Millwood). 2002 Jul-Aug;21(4):222-31
12117133
Front Psychol. 2016 Jan 08;6:2013
26779108
BMJ. 2008 Sep 29;337:a1655
18824488
BMC Public Health. 2014 Jun 25;14:648
24966036
Health Aff (Millwood). 2013 Feb;32(2):321-7
23381525
Health Aff (Millwood). 2009 Mar-Apr;28(2):w219-31
19174383
J Health Care Poor Underserved. 2005 Nov;16(4):808-24
16311500
J Cardiopulm Rehabil Prev. 2013 Mar-Apr;33(2):113-23
23434613
J Am Board Fam Med. 2012 Mar-Apr;25(2):158-67
22403196
Patient. 2016 Oct;9(5):383-93
27048393
Patient Educ Couns. 2016 Jan;99(1):108-16
26293542
J Cardiovasc Nurs. 2013 Jan-Feb;28(1):20-34
22343209
Int J Nurs Pract. 1999 Sep;5(3):132-6
10769621
BMJ. 2007 Mar 3;334(7591):455-9
17332585
Stud Health Technol Inform. 2014;203:85-95
26630515
Res Brief. 2008 Oct;(8):1-9
18946947
BMJ. 2005 Nov 19;331(7526):1199-201
16293845
Patient Educ Couns. 2010 Nov;81(2):207-13
20223617
Patient Educ Couns. 2010 Mar;78(3):350-6
20202780
J Gen Intern Med. 2012 May;27(5):520-6
22127797
Lancet. 2008 Jul 19;372(9634):246-55
18640461
Scand J Public Health. 2011 May;39(3):262-71
21427147
Genome Med. 2014 Feb 26;6(2):16
24571651
Med J Aust. 2008 Nov 17;189(S10):S9-S13
19143585
Am Psychol. 2000 Jan;55(1):5-14
11392865
J Epidemiol Community Health. 1997 Oct;51(5):469-71
9425453
Patient Educ Couns. 2016 Jan;99(1):164-8
26227577
Diabetes Care. 1995 Jul;18(7):943-9
7555554
BMJ Open. 2015 Mar 16;5(3):e005582
25776041
Front Psychol. 2015 Mar 27;6:274
25870566
PLoS One. 2015 May 08;10(5):e0125820
25954817
Patient Educ Couns. 2005 May;57(2):153-7
15911187
Psychooncology. 2016 May;25(5):574-81
26804708
J Ambul Care Manage. 2009 Oct-Dec;32(4):320-7
19888008
AIDS Care. 2016;28(5):620-7
26695005
J Nerv Ment Dis. 2004 Sep;192(9):629-34
15348980
Health Aff (Millwood). 2016 Apr;35(4):563
27044951
BMJ. 2000 Sep 16;321(7262):694-6
10987780
Qual Saf Health Care. 2005 Dec;14(6):398-400
16326781
Health Educ Q. 1984 Spring;11(1):1-47
6392204
Arch Intern Med. 2002 Nov 11;162(20):2269-76
12418941
Am Psychol. 2005 Jul-Aug;60(5):410-21
16045394
J Eval Clin Pract. 2010 Feb;16(1):166-74
20367828
Disabil Rehabil. 2013 Feb;35(3):236-43
22691088
Qual Life Res. 2015 May;24(5):1087-96
25373927
Nature. 2008 Feb 7;451(7179):716-9
18204438
J Clin Psychol. 2009 May;65(5):467-87
19301241
Health Aff (Millwood). 2001 Nov-Dec;20(6):114-27
11816651
J Health Care Poor Underserved. 2014 May;25(2):591-604
24858870
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004273
17253501
Res Theory Nurs Pract. 2009;23(2):148-60
19558029
J Ambul Care Manage. 2007 Jan-Mar;30(1):21-9
17170635