Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

被引:116
作者
Chen, Jie [1 ]
Mullins, C. Daniel [1 ]
Novak, Priscilla [1 ]
Thomas, Stephen B. [1 ]
机构
[1] Univ Maryland, College Pk, MD 20742 USA
基金
美国医疗保健研究与质量局;
关键词
education; empowerment; health behavior; health disparities; health policy; patient; race; ethnicity; SHARED DECISION-MAKING; RESIDENTIAL SEGREGATION; PROVIDER COMMUNICATION; ETHNIC DISPARITIES; SELF-MANAGEMENT; CENTERED CARE; LATER LIFE; ENGAGEMENT; FRAMEWORK; PHYSICIAN;
D O I
10.1177/1090198115579415
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and self-determination for their own health and health care. We propose a patient-centered, multilevel activation and empowerment framework (individual-, health care professional-, community-, and health care delivery system-level) to inform the development of culturally informed personalized patient activation and empowerment (P-PAE) interventions to improve population health and reduce racial and ethnic disparities. We discuss relevant Affordable Care Act payment and delivery policy reforms and how they affect patient activation and empowerment. Such policies include Accountable Care Organizations and value-based purchasing, patient-centered medical homes, and the community health benefit. Challenges and possible solutions to implementing the P-PAE are discussed. Comprehensive and longitudinal data sets with consistent P-PAE measures are needed to conduct comparative effectiveness analyses to evaluate the optimal P-PAE model. We believe the P-PAE model is timely and sustainable and will be critical to engaging patients in their treatment, developing patients' abilities to manage their health, helping patients express concerns and preferences regarding treatment, empowering patients to ask questions about treatment options, and building up strategic patient-provider partnerships through shared decision making.
引用
收藏
页码:25 / 34
页数:10
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