title: Enhancing Doctors' Competencies in Communication With and Activation of Older Patients: The Promoting Active Aging (PRACTA) Computer-Based Intervention Study.
abstract: Demographic changes over the past decades call for the promotion of health and disease prevention for older patients, as well as strategies to enhance their independence, productivity, and quality of life.
  
  
  
  Our objective was to examine the effects of a computer-based educational intervention designed for general practitioners (GPs) to promote active aging.
  
  
  
  The Promoting Active Aging (PRACTA) study consisted of a baseline questionnaire, implementation of an intervention, and a follow-up questionnaire that was administered 1 month after the intervention. A total of 151 primary care facilities (response rate 151/767, 19.7%) and 503 GPs (response rate 503/996, 50.5%) agreed to participate in the baseline assessment. At the follow-up, 393 GPs filled in the questionnaires (response rate, 393/503, 78.1%), but not all of them took part in the intervention. The final study group of 225 GPs participated in 3 study conditions: e-learning (knowledge plus skills modelling, n=42), a pdf article (knowledge only, n=89), and control (no intervention, n=94). We measured the outcome as scores on the Patients Expectations Scale, Communication Scale, Attitude Toward Treatment and Health Scale, and Self-Efficacy Scale.
  
  
  
  GPs participating in e-learning demonstrated a significant rise in their perception of older patients' expectations for disease explanation (Wald χ2=19.7, P<.001) and in perception of motivational aspect of older patients' attitude toward treatment and health (Wald χ2=8.9, P=.03) in comparison with both the control and pdf article groups. We observed additional between-group differences at the level of statistical trend. GPs participating in the pdf article intervention demonstrated a decline in self-assessed communication, both at the level of global scoring (Wald χ2=34.5, P<.001) and at the level of 20 of 26 specific behaviors (all P<.05). Factors moderating the effects of the intervention were the number of patients per GP and the facility's organizational structure.
  
  
  
  Both methods were suitable, but in different areas and under different conditions. The key benefit of the pdf article intervention was raising doctors' reflection on limitations in their communication skills, whereas e-learning was more effective in changing their perception of older patients' proactive attitude, especially among GPs working in privately owned facilities and having a greater number of assigned patients. Although we did not achieve all expected effects of the PRACTA intervention, both its forms seem promising in terms of enhancing the competencies of doctors in communication with and activation of older patients.
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Dorota
authors.identifier: 0000-0002-0707-9503
authors.initials: D
authors.lastname: Wlodarczyk
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.identifier: 0000-0002-9129-319X
authors.initials: J
authors.lastname: Chylińska
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Magdalena
authors.identifier: 0000-0001-9451-8561
authors.initials: M
authors.lastname: Lazarewicz
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marta
authors.identifier: 0000-0003-0221-4494
authors.initials: M
authors.lastname: Rzadkiewicz
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Mariusz
authors.identifier: 0000-0002-5207-8323
authors.initials: M
authors.lastname: Jaworski
authors.affiliation: Second Faculty of Medicine, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Miroslawa
authors.identifier: 0000-0003-4946-671X
authors.initials: M
authors.lastname: Adamus
authors.affiliation: NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Gørill
authors.identifier: 0000-0003-0090-6462
authors.initials: G
authors.lastname: Haugan
authors.affiliation: NTNU Center for Health Promotion Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Monica
authors.identifier: 0000-0002-7698-7302
authors.initials: M
authors.lastname: Lillefjell
authors.affiliation: NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Geir Arild
authors.identifier: 0000-0003-3806-1389
authors.initials: GA
authors.lastname: Espnes
mesh_terms: D000367:Age Factors; D003142:Communication; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011361:Professional Competence; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: active aging; e-learning; general practioners; health communication; health services for the aged; professional competence; psychosocial competencies; seniors’ attitude toward treatment and health; seniors’ expectations