Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study
Abstract Background Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09785-x |
| _version_ | 1797577273282396160 |
|---|---|
| author | Gennaro Di Tosto Jennifer L. Hefner Daniel M. Walker Megan E. Gregory Ann Scheck McAlearney Cynthia J. Sieck |
| author_facet | Gennaro Di Tosto Jennifer L. Hefner Daniel M. Walker Megan E. Gregory Ann Scheck McAlearney Cynthia J. Sieck |
| author_sort | Gennaro Di Tosto |
| collection | DOAJ |
| description | Abstract Background Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives designed to help patients participate in health decisions, there remains a limited understanding of engagement from the perspective of patients and a lack of measures designed to capture the multi-faceted nature of the concept. Methods Development of a concept map of patient engagement followed a five-step modified Group Concept Mapping (GCM) methodology of preparation, generation, structuring, analysis and interpretation. We engaged a Project Advisory Committee at each step, along with three rounds of survey collection from clinicians and patients for element generation (272 clinicians, 61 patients), statement sorting (30 clinicians, 15 patients), and ranking and rating of statements (159 clinicians, 67 patients). The survey of three separate samples, as opposed to focus groups of ‘experts,’ was an intentional decision to gain a broad perspective about the concept of patient engagement. We conducted the structure and analysis steps within the groupwisdom concept mapping software. Results The final concept map comprised 47 elements organized into 5 clusters: Relationship with Provider, Patient Attitudes and Behaviors, Access, Internal Resources and External Resources. There was considerable agreement in the way elements in each cluster were rated by patients and clinicians. An analysis of the importance of the constitutive elements of patient engagement relative to their addressability highlighted actionable items in the domain of Relationship with Provider, aimed at building trust and enabling patients to ask questions. At the same time, the analysis also identified elements traditionally considered barriers to engagement, like personal access to the internet and the patient’s level of digital literacy, as difficult to address by the healthcare system, but also relatively less important for patients. Conclusions Through our GCM approach, incorporating perspectives of both patients and clinicians, we identified items that can be used to assess patient engagement efforts by healthcare systems. As a result, our study offers specific insight into areas that can be targeted for intervention by healthcare systems to improve patient engagement. |
| first_indexed | 2024-03-10T22:05:53Z |
| format | Article |
| id | doaj.art-e49440ef2114441db6965057f708eec3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-10T22:05:53Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-e49440ef2114441db6965057f708eec32023-11-19T12:48:42ZengBMCBMC Health Services Research1472-69632023-08-0123111210.1186/s12913-023-09785-xDevelopment of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping studyGennaro Di Tosto0Jennifer L. Hefner1Daniel M. Walker2Megan E. Gregory3Ann Scheck McAlearney4Cynthia J. Sieck5CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State UniversityDepartment of Family and Community Medicine, College of Medicine, The Ohio State UniversityCATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State UniversityDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of FloridaCATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State UniversityCenter for Health Equity, Dayton Children’s HospitalAbstract Background Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives designed to help patients participate in health decisions, there remains a limited understanding of engagement from the perspective of patients and a lack of measures designed to capture the multi-faceted nature of the concept. Methods Development of a concept map of patient engagement followed a five-step modified Group Concept Mapping (GCM) methodology of preparation, generation, structuring, analysis and interpretation. We engaged a Project Advisory Committee at each step, along with three rounds of survey collection from clinicians and patients for element generation (272 clinicians, 61 patients), statement sorting (30 clinicians, 15 patients), and ranking and rating of statements (159 clinicians, 67 patients). The survey of three separate samples, as opposed to focus groups of ‘experts,’ was an intentional decision to gain a broad perspective about the concept of patient engagement. We conducted the structure and analysis steps within the groupwisdom concept mapping software. Results The final concept map comprised 47 elements organized into 5 clusters: Relationship with Provider, Patient Attitudes and Behaviors, Access, Internal Resources and External Resources. There was considerable agreement in the way elements in each cluster were rated by patients and clinicians. An analysis of the importance of the constitutive elements of patient engagement relative to their addressability highlighted actionable items in the domain of Relationship with Provider, aimed at building trust and enabling patients to ask questions. At the same time, the analysis also identified elements traditionally considered barriers to engagement, like personal access to the internet and the patient’s level of digital literacy, as difficult to address by the healthcare system, but also relatively less important for patients. Conclusions Through our GCM approach, incorporating perspectives of both patients and clinicians, we identified items that can be used to assess patient engagement efforts by healthcare systems. As a result, our study offers specific insight into areas that can be targeted for intervention by healthcare systems to improve patient engagement.https://doi.org/10.1186/s12913-023-09785-xPatient engagementPatient-centered careGroup concept mapping. |
| spellingShingle | Gennaro Di Tosto Jennifer L. Hefner Daniel M. Walker Megan E. Gregory Ann Scheck McAlearney Cynthia J. Sieck Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study BMC Health Services Research Patient engagement Patient-centered care Group concept mapping. |
| title | Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study |
| title_full | Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study |
| title_fullStr | Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study |
| title_full_unstemmed | Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study |
| title_short | Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study |
| title_sort | development of a conceptual model of the capacity for patients to engage in their health care a group concept mapping study |
| topic | Patient engagement Patient-centered care Group concept mapping. |
| url | https://doi.org/10.1186/s12913-023-09785-x |
| work_keys_str_mv | AT gennaroditosto developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy AT jenniferlhefner developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy AT danielmwalker developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy AT meganegregory developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy AT annscheckmcalearney developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy AT cynthiajsieck developmentofaconceptualmodelofthecapacityforpatientstoengageintheirhealthcareagroupconceptmappingstudy |