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Published in: Journal of Immigrant and Minority Health 6/2016

01-12-2016 | Original Paper

Patient Activation is Inconsistently Associated with Positive Health Behaviors Among Obese Safety Net Patients

Authors: Mona AuYoung, Ninez A. Ponce, O. Kenrik Duru, Arturo Vargas Bustamante, Carol M. Mangione, Hector P. Rodriguez

Published in: Journal of Immigrant and Minority Health | Issue 6/2016

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Abstract

We examine the association of patient activation and physical activity and fruit and vegetable consumption among obese safety net patients. Adult obese patients (n = 198) of three safety net clinics completed a survey assessing patient activation, physical activity, fruit and vegetable consumption, care experiences, and health status. Multivariate logistic regression models incrementally assessed the adjusted relation of patient activation and physical activity and fruit and vegetable consumption. In adjusted analyses, higher activated patients had higher odds [Odds ratio (OR) 1.58, p < 0.01] of consuming fruits and vegetables daily than less activated patients. There was no significant association between patient activation and regular physical activity. Engaging in regular physical activity appears to be difficult, even for highly activated patients. In contrast, additional fruit and vegetable consumption is a relatively easier change. Patient activation was inconsistently associated with two positive health behaviors among obese safety net patients.
Literature
1.
go back to reference Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff. 2009;28:75–85.CrossRef Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff. 2009;28:75–85.CrossRef
2.
go back to reference Rothman AA, Wagner EH. Chronic illness management: what is the role of primary care? Ann Intern Med. 2003;183:256–61.CrossRef Rothman AA, Wagner EH. Chronic illness management: what is the role of primary care? Ann Intern Med. 2003;183:256–61.CrossRef
3.
go back to reference Desouza CV, Padala PR, Haynatzki G, Anzures P, Demasi C, Shivaswamy V. Role of apathy in the effectiveness of weight management programmes. Diabetes Obes Metab. 2012;14:419–23.CrossRefPubMed Desouza CV, Padala PR, Haynatzki G, Anzures P, Demasi C, Shivaswamy V. Role of apathy in the effectiveness of weight management programmes. Diabetes Obes Metab. 2012;14:419–23.CrossRefPubMed
4.
go back to reference Tsai AC, Morton SC, Mangione CM, Keeler EB. A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care. 2005;11:478–88.PubMedPubMedCentral Tsai AC, Morton SC, Mangione CM, Keeler EB. A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care. 2005;11:478–88.PubMedPubMedCentral
5.
go back to reference Rittenhouse DR, Casalino LP, Shortell SM, et al. Small and medium-size physician practices use few patient-centered medical home processes. Health Aff. 2011;30:1575–84.CrossRef Rittenhouse DR, Casalino LP, Shortell SM, et al. Small and medium-size physician practices use few patient-centered medical home processes. Health Aff. 2011;30:1575–84.CrossRef
6.
go back to reference Shortell SM, Gillies R, Siddique J, et al. Improving chronic illness care: a longitudinal cohort analysis of large physician organizations. Med Care. 2009;42:932–39.CrossRef Shortell SM, Gillies R, Siddique J, et al. Improving chronic illness care: a longitudinal cohort analysis of large physician organizations. Med Care. 2009;42:932–39.CrossRef
7.
go back to reference Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff. 2013;32:223–31.CrossRef Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff. 2013;32:223–31.CrossRef
8.
go back to reference Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff. 2013;32:207–14.CrossRef Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff. 2013;32:207–14.CrossRef
9.
go back to reference Greene J, Hibbard JH. Why does patient activation matter? an examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2011;27:520–6.CrossRefPubMedCentral Greene J, Hibbard JH. Why does patient activation matter? an examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2011;27:520–6.CrossRefPubMedCentral
10.
go back to reference Rask KJ, Ziemer DC, Kohler SA, Hawley JN, Arinde FJ, Barnes CS. Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent population. Diabetes Educ. 2009;35:622–30.CrossRefPubMed Rask KJ, Ziemer DC, Kohler SA, Hawley JN, Arinde FJ, Barnes CS. Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent population. Diabetes Educ. 2009;35:622–30.CrossRefPubMed
11.
go back to reference Alexander JA, Hearld LR, Mittler JN, Harvey J. Patient–physician role relationships and patient activation among individuals with chronic illness. Health Serv Res. 2012;47:1201–23.CrossRefPubMed Alexander JA, Hearld LR, Mittler JN, Harvey J. Patient–physician role relationships and patient activation among individuals with chronic illness. Health Serv Res. 2012;47:1201–23.CrossRefPubMed
12.
go back to reference Tarn DM, Young HN, Craig BM. Development of the patient approach and views toward healthcare communication (PAV-COM) measure among older adults. BMC Health Serv Res. 2012;12:289.CrossRefPubMedPubMedCentral Tarn DM, Young HN, Craig BM. Development of the patient approach and views toward healthcare communication (PAV-COM) measure among older adults. BMC Health Serv Res. 2012;12:289.CrossRefPubMedPubMedCentral
13.
go back to reference Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Aff (Millwood). 2010;29:1310–8.CrossRef Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Aff (Millwood). 2010;29:1310–8.CrossRef
14.
go back to reference Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39:1005–26.CrossRefPubMedPubMedCentral Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39:1005–26.CrossRefPubMedPubMedCentral
15.
go back to reference Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Serv Res. 2005;40:1918–30.CrossRefPubMedPubMedCentral Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Serv Res. 2005;40:1918–30.CrossRefPubMedPubMedCentral
16.
go back to reference Hibbard JH, Mahoney E. Toward a theory of patient and consumer activation. Patient Educ Couns. 2010;78:377–81.CrossRefPubMed Hibbard JH, Mahoney E. Toward a theory of patient and consumer activation. Patient Educ Couns. 2010;78:377–81.CrossRefPubMed
17.
go back to reference Chubak J, Anderson ML, Saunders KW, et al. Predictors of 1-year change in patient activation in older adults with diabetes mellitus and heart disease. J Am Geriatr Soc. 2012;60:1316–21.CrossRefPubMed Chubak J, Anderson ML, Saunders KW, et al. Predictors of 1-year change in patient activation in older adults with diabetes mellitus and heart disease. J Am Geriatr Soc. 2012;60:1316–21.CrossRefPubMed
18.
go back to reference Munson GW, Wallston KA, Dittus RS, Speroff T, Roumie CL. Activation and perceived expectancies: correlations with health outcomes among veterans with inflammatory bowel disease. J Gen Intern Med. 2009;24:809–15.CrossRefPubMedPubMedCentral Munson GW, Wallston KA, Dittus RS, Speroff T, Roumie CL. Activation and perceived expectancies: correlations with health outcomes among veterans with inflammatory bowel disease. J Gen Intern Med. 2009;24:809–15.CrossRefPubMedPubMedCentral
19.
go back to reference Johnson SS, Paiva AL, Cummins CO, et al. Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Prev Med. 2008;46:238–46.CrossRefPubMed Johnson SS, Paiva AL, Cummins CO, et al. Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Prev Med. 2008;46:238–46.CrossRefPubMed
20.
go back to reference Sallis R. Developing healthcare systems to support exercise: exercise as the fifth vital sign. Br J Sports Med. 2011;45:473–4.CrossRefPubMed Sallis R. Developing healthcare systems to support exercise: exercise as the fifth vital sign. Br J Sports Med. 2011;45:473–4.CrossRefPubMed
21.
go back to reference Paxton AE, Strycker LA, Toobert DJ, Ammerman AS, Glasgow RE. Starting the conversation. Am J Prev Med. 2011;40:67–71.CrossRefPubMed Paxton AE, Strycker LA, Toobert DJ, Ammerman AS, Glasgow RE. Starting the conversation. Am J Prev Med. 2011;40:67–71.CrossRefPubMed
22.
go back to reference Browne K, Roseman D, Shaller D, Edgman-Levitan S. Analysis and commentary measuring patient experience as a strategy for improving primary care. Health Aff. 2010;29:921–5.CrossRef Browne K, Roseman D, Shaller D, Edgman-Levitan S. Analysis and commentary measuring patient experience as a strategy for improving primary care. Health Aff. 2010;29:921–5.CrossRef
23.
go back to reference Anastario MP, Rodriguez HP, Gallagher PM, et al. A randomized trial comparing mail versus in-office distribution of the CAHPS Clinician and Group Survey. Health Serv Res. 2010;45:1345–59.CrossRefPubMedPubMedCentral Anastario MP, Rodriguez HP, Gallagher PM, et al. A randomized trial comparing mail versus in-office distribution of the CAHPS Clinician and Group Survey. Health Serv Res. 2010;45:1345–59.CrossRefPubMedPubMedCentral
24.
go back to reference Jenkinson C, Layte R, Jenkinson D, et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med. 1997;19:179–86.CrossRef Jenkinson C, Layte R, Jenkinson D, et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med. 1997;19:179–86.CrossRef
25.
go back to reference Hibbard JH, Mahoney ER, Stock R, Tusler M. Do increases in patient activation result in improved self-management behaviors? Health Serv Res. 2007;42:1443–63.CrossRefPubMedPubMedCentral Hibbard JH, Mahoney ER, Stock R, Tusler M. Do increases in patient activation result in improved self-management behaviors? Health Serv Res. 2007;42:1443–63.CrossRefPubMedPubMedCentral
26.
go back to reference Harvey L, Fowles JB, Xi M, Terry P. When activation changes, what else changes? the relationship between change in patient activation measure (PAM) and employees’ health status and health behaviors. Patient Educ Couns. 2012;88:338–43.CrossRefPubMed Harvey L, Fowles JB, Xi M, Terry P. When activation changes, what else changes? the relationship between change in patient activation measure (PAM) and employees’ health status and health behaviors. Patient Educ Couns. 2012;88:338–43.CrossRefPubMed
27.
go back to reference Drieling RL, Ma J, Stafford RS. Evaluating clinic and community-based lifestyle interventions for obesity reduction in a low-income Latino neighborhood: Vivamos Activos Fair Oaks Program. BMC Public Health. 2011;11:98.CrossRefPubMedPubMedCentral Drieling RL, Ma J, Stafford RS. Evaluating clinic and community-based lifestyle interventions for obesity reduction in a low-income Latino neighborhood: Vivamos Activos Fair Oaks Program. BMC Public Health. 2011;11:98.CrossRefPubMedPubMedCentral
28.
go back to reference Deen D, Lu WH, Weintraub MR, Maranda MJ, Elshafey S, Gold MR. The impact of different modalities for activating patients in a community health center setting. Patient Educ Couns. 2012;89:178–83.CrossRefPubMed Deen D, Lu WH, Weintraub MR, Maranda MJ, Elshafey S, Gold MR. The impact of different modalities for activating patients in a community health center setting. Patient Educ Couns. 2012;89:178–83.CrossRefPubMed
29.
go back to reference Alegría M, Sribney W, Perez D, Laderman M, Keefe K. The role of patient activation on patient-provider communication and quality of care for US and foreign born Latino patients. J Gen Intern Med. 2009;24:534–41.CrossRefPubMedPubMedCentral Alegría M, Sribney W, Perez D, Laderman M, Keefe K. The role of patient activation on patient-provider communication and quality of care for US and foreign born Latino patients. J Gen Intern Med. 2009;24:534–41.CrossRefPubMedPubMedCentral
30.
go back to reference Lubetkin EI, Lu W-H, Gold MR. Levels and correlates of patient activation in health center settings: building strategies for improving health outcomes. J Health Care Poor Underserved. 2010;21:796–808.CrossRefPubMed Lubetkin EI, Lu W-H, Gold MR. Levels and correlates of patient activation in health center settings: building strategies for improving health outcomes. J Health Care Poor Underserved. 2010;21:796–808.CrossRefPubMed
31.
go back to reference Cunningham PJ, Hibbard J, Gibbons CB. Raising low ‘patient activation’ rates among Hispanic immigrants may equal expanded coverage in reducing access disparities. Health Aff. 2011;30:1888–94.CrossRef Cunningham PJ, Hibbard J, Gibbons CB. Raising low ‘patient activation’ rates among Hispanic immigrants may equal expanded coverage in reducing access disparities. Health Aff. 2011;30:1888–94.CrossRef
32.
go back to reference Cunningham PJ, Hibbard JH. How engaged are consumers in their health and health care, and why does it matter?. Washington, DC: Center for Studying Health System Change; 2008. Cunningham PJ, Hibbard JH. How engaged are consumers in their health and health care, and why does it matter?. Washington, DC: Center for Studying Health System Change; 2008.
33.
go back to reference Otero-Sabogal R, Arretz D, Siebold S, et al. Physician-community health worker partnering to support diabetes self-management in primary care. Qual Prim Care. 2010;18:363–72.PubMed Otero-Sabogal R, Arretz D, Siebold S, et al. Physician-community health worker partnering to support diabetes self-management in primary care. Qual Prim Care. 2010;18:363–72.PubMed
34.
go back to reference Dixon A, Hibbard J, Tusler M. How do people with different levels of activation self-manage their chronic conditions? Patient. 2009;2:257–68.CrossRef Dixon A, Hibbard J, Tusler M. How do people with different levels of activation self-manage their chronic conditions? Patient. 2009;2:257–68.CrossRef
Metadata
Title
Patient Activation is Inconsistently Associated with Positive Health Behaviors Among Obese Safety Net Patients
Authors
Mona AuYoung
Ninez A. Ponce
O. Kenrik Duru
Arturo Vargas Bustamante
Carol M. Mangione
Hector P. Rodriguez
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 6/2016
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-015-0285-y

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