Risk Management and Healthcare Policy Dovepress Improving Health Outcomes with Better Patient Understanding and Education Specific Conditions or Problems Risk Management and Healthcare Policy 2010:3 Types of Interventions Risk Management and Healthcare Policy 2010:3 Information Provision Alone Healt

A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual's competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been promoted as one such potential approach. Chronic disease self-management and preventive health programs mainly focus on promoting informed lifestyle choices, risk-factor modification, and active patient self-management of chronic diseases. 1 Such a process relies heavily on better information and communication practices. The logic of health reform that emphasizes preventive and enhanced primary models of care is an expanded role for informed, active consumers interacting with responsive health care teams. 1 Most observers agree that this central role demands improved education and understanding of health behavior and chronic disease management. However, for individuals to realize the benefits of health education also requires a high level of participation and engagement, ie, action or behavior …