Project Summary
Background: Improving patient empowerment represents an important way to reduce inequities in patient adherence and outcomes. This is particularly so for patients living with chronic conditions such as HIV infection that require active patient involvement. Our team, which includes HIV patients, doctors, and HIV organizations, developed a training program to use a personal health record (PHR) for people living with HIV. Together with peer trainers, we will teach patients how to use their iPod and an interactive PHR, and how to ask their doctors questions that are meaningful to them. We will evaluate the effect of the training program by comparing patients who receive the program to those who don't.
Objectives: The purpose of the program is to empower patients, improve patients' health care and health, and reduce disparities. Our project has four major aims:
- improve patient empowerment;
- increase patients' receipt of evidence-based care;
- improve patients' health;
- reduce disparities in empowerment.
We will assess patient empowerment based on the Patient Activation Measure and based on patient decision making, perceived involvement in care, and ability to seek out health information on the Web. We will assess quality of care (control of HIV and receipt of evidence-based cancer screening and immunizations). We will assess change in health using widely used measures of physical and mental health. We will determine whether the intervention affects disparities in empowerment.
Methods: We will assess the effect of a multimodal intervention on the empowerment of HIV patients by randomly assigning patients to the program or not. The program includes four components:
- a customized personal health record (PHR) for HIV patients;
- six 90-minute group-based training sessions in use of the iPod and the PHR;
- a pre-visit coaching session;
- clinician training in supporting patient empowerment.
We will compare changes in key measures between patients who receive the program with those who don't. Patient
Outcomes: We expect that patients who receive the intervention will show greater improvements in empowerment and reduction in disparities by race, ethnicity, and educational level for these facets of empowerment. Specifically, the intervention will increase activation, eHealth abilities, decision making, involvement in care, medication adherence, care quality, and health. Disparities in these measures will be smaller than those in the usual care group.
Fiscella K, Boyd M, Brown J, Carroll J, Cassells A, Corales R, Cross W, El'Daher N, Farah S, Fine S, Fowler R, Hann A, Luque A, Rodriquez J, Sanders M, Tobin J. Activation of persons living with HIV for treatment, the great study. BMC Public Health. 2015 Oct 16;15(1):1056. doi: 10.1186/s12889-015-2382-1. PubMed PMID: 26474979; PubMed Central PMCID: PMC4608105.
Project Details
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