Opportunity or Burden? A Behavioral Framework for Patient Engagement

Area of Science:

• Health Services Research
• Patient Engagement
• Qualitative Research Methods

Background:

• Patient engagement is crucial but challenging to implement, especially in vulnerable populations.
• A lack of suitable measurement frameworks for these groups hinders progress.
• This study aimed to address this gap by refining a conceptual framework for patient engagement propensity.

Purpose of the Study:

• To refine the domains of patient engagement behavior.
• To identify key behaviors for engaging with providers and health systems.
• To illustrate how self-efficacy influences engagement opportunities and difficulties.

Main Methods:

• Qualitative study involving semistructured interviews with veterans receiving care.
• Analysis of patient perspectives using the framework method.
• Elicitation of patient experiences within the Veterans Health Administration.

Main Results:

• A 4-domain engagement framework was developed: Self-Management, Health Information Use, Collaborative Communication, and Healthcare Navigation.
• Propensity to engage is conceptualized as cumulative self-efficacy across these domains.
• Engagement behaviors are collaborative and influenced by cultural factors like collective efficacy.

Conclusions:

• The developed framework can assess a patient's propensity to engage in care.
• It can inform interventions aimed at improving patient engagement, particularly in public sector settings.
• The framework's focus on self-efficacy is valuable for populations facing social risks.