Using Systematic Measurement to Target Consumer Activation Strategies

Current policy directions place high expectations on consumers, pressing them to adopt new roles and behaviors. The price of failing to meet these expectations will be high for the individual, for the care delivery system, and for the society as a whole. Yet there is limited support in place to help consumers meet these expectations. The article reviews the major approaches used to stimulate consumer engagement in health and health care. The concept of activation is explored as a possible organizing construct for informing strategies to increase consumer involvement in health. Illustrative data are presented that show how activation levels are associated with engaging in specific health behaviors. The strategy of measuring activation and calibrating both the type and the amount of support for consumers is discussed as a way to improve current approaches. Tailoring activation to the individual, group, and community level is also explored.

[1]  W. Miller,et al.  Motivational interviewing: preparing people for change. , 2002 .

[2]  D. Roblin,et al.  Translating Primary Care Practice Climate into Patient Activation: The Role of Patient Trust in Physician , 2008, Medical care.

[3]  J. Hibbard,et al.  Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. , 2004, Health services research.

[4]  D. Andrich A rating formulation for ordered response categories , 1978 .

[5]  K. Glanz,et al.  Health behavior and health education : theory, research, and practice , 1991 .

[6]  Judith H Hibbard,et al.  Development and testing of a short form of the patient activation measure. , 2005, Health services research.

[7]  N. Wareham,et al.  Evidence Base for Diabetes Care , 2002 .

[8]  Susan A. Murphy,et al.  A Conceptual Framework for Adaptive Preventive Interventions , 2004, Prevention Science.

[9]  M. Battersby,et al.  The Partners in Health scale: The development and psychometric properties of a generic assessment scale for chronic condition self-management , 2003 .

[10]  B. Rimer,et al.  Advancing Tailored Health Communication: A Persuasion and Message Effects Perspective , 2006 .

[11]  M. Stewart,et al.  Communication patterns of primary care physicians. , 1997, JAMA.

[12]  J. Schaefer,et al.  Collaborative Management of Chronic Illness , 1997, Annals of Internal Medicine.

[13]  Daniel H Solomon,et al.  Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. , 2004, Archives of internal medicine.

[14]  James H. Gilmore,et al.  Markets of one : creating customer-unique value through mass customization , 2000 .

[15]  Joseph N. Cappella,et al.  Integrating Message Effects and Behavior Change Theories: Organizing Comments and Unanswered Questions , 2006 .

[16]  J E Blair,et al.  Social Marketing , 1995, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[17]  June A. Flora,et al.  Achieving Improvements in Overall Health Orientation , 1999 .

[18]  Vic Hasselblad,et al.  Interventions used in disease management programmes for patients with chronic illnesswhich ones work? Meta-analysis of published reports , 2002, BMJ : British Medical Journal.

[19]  Judith H Hibbard,et al.  Do increases in patient activation result in improved self-management behaviors? , 2007, Health services research.

[20]  Magnus Stenbeck,et al.  Are Likert scales unidimensional , 1987 .

[21]  N. Wallerstein,et al.  Empowerment Education: Freire's Ideas Adapted to Health Education , 1988, Health education quarterly.

[22]  Margaret Maglione,et al.  Interventions That Increase Use of Adult Immunization and Cancer Screening Services , 2002, Annals of Internal Medicine.

[23]  A. Stewart,et al.  Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. , 1999, Medical care.

[24]  D. Roter,et al.  What is the Evidence that Increasing Engagement of Individuals in Self‐Management Improves the Processes and Outcomes of Care? , 2010 .

[25]  G. Masters,et al.  Rating scale analysis , 1982 .

[26]  Sally Morton,et al.  Meta-Analysis: Chronic Disease Self-Management Programs for Older Adults , 2005, Annals of Internal Medicine.

[27]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[28]  B. Wright,et al.  Best test design , 1979 .

[29]  Kevin G Volpp,et al.  A randomized, controlled trial of financial incentives for smoking cessation. , 2009, The New England journal of medicine.

[30]  R. Herzlinger,et al.  Let's put consumers in charge of health care. , 2002, Harvard business review.

[31]  Robert W Massof,et al.  The Measurement of Vision Disability , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[32]  P E Nelbach Partners in health. , 1968, Bedside nurse.

[33]  J. Iglehart Changing health insurance trends. , 2002, The New England journal of medicine.