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What was the research about?

Most health care focuses on what is wrong with people. In this study, the research team focused instead on people’s strengths. The team wanted to identify the personal strengths that patients might find helpful in managing chronic illness or improving health habits. To that end, the team created a computer app to help patients recognize personal strengths they can draw on. Then, the team tried to identify times when bringing patient strengths into health care might help patients.

What were the results?

Patients in the study reported 30 personal strengths that might be helpful in managing illness or improving health habits. The strengths fit into three groups:

• Personal traits, such as having a positive attitude
• Relationships, such as having family or friends who support the patient
• Access to community resources, such as knowing where to go for help with a health problem

A design team of patients, caregivers, and healthcare professionals worked with the research team to create an app called Strengths Collector. The app shows four videos of patients talking about knowing their strengths. In the app, users pick their strengths from a list and rate how important each strength is for a visit to their doctor. Strengths then appear on the app in order of importance for that visit. Patients and doctors can discuss this list to plan care.

The design team also identified situations when bringing strengths into health care might be helpful for patients. Examples include

• Managing diabetes
• Managing ongoing pain
• When patients have to use health care often

Who was in the study?

The research team gathered information from 76 patients with chronic illnesses. Of these patients, 41 were African American, 20 were white, 1 was Asian, 1 was multi-race, and 13 were unknown race. All patients were from Cleveland, Ohio.

What did the research team do?

To create a list of strengths that might help patients manage illnesses, the research team met with 76 patients and healthcare professionals. Then, the team invited 19 patients, caregivers, and healthcare professionals to form a design team. The design team worked with computer programmers to create the app and identify when doctors and patients can use patient strengths in health care.

What were the limits of the study?

The study only tested the app with small numbers of patients. The team also wasn’t able to test if using patient strengths improved patient health.

Future research could look at whether patients and clinicians can use the app in real-world visits and whether strengths-based care improves patient health.

How can people use the results?

Healthcare professionals and patients can use the list of strengths to think about ways to help patients better manage illness or improve health habits. Patients can use the app to find their strengths to help plan care with their doctors.

Objective

(1) To identify personal strengths relevant to chronic illness management; (2) To create a tablet-based app to help patients identify these strengths when managing chronic illness; (3) To identify scenarios in which a strengths-based approach might be helpful

Study Design

Health care for patients has traditionally focused on deficits, such as diseases, risk factors, and unhealthy behaviors rather than strengths, such as skills or resources. Academic researchers worked with patients with multiple chronic illnesses and primary care physicians, nurse practitioners, nurses, and social workers to conduct this study in two phases.

In the first phase, the research team conducted focus groups and interviews with 76 patients who had chronic conditions and got care at three safety net practices in Cleveland, Ohio. Of these patients, 41 were African American, 20 were white, 1 was Asian, 1 was multi-race, and 13 were unknown race. From the focus groups and interviews, the team created a list of patient-identified strengths relevant to managing chronic illness or improving health habits.

During the second phase, the research team invited 19 patients, caregivers, and healthcare professionals to form a design team. The design team had 10 two-hour sessions to refine the list of strengths. With assistance from programmers, the design team developed a tablet-based app to help patients identify their personal strengths. The app included four videos of patients speaking about the importance of patients knowing their strengths. It directed patients to select their strengths from the design team’s list and rate the relevance of each strength to healthcare visits for chronic illnesses. The app then generated a prioritized list of the patient’s strengths to discuss during the healthcare visit. Finally, the design team identified clinical situations in which patient strengths would be particularly helpful.

Results

Patients reported 30 personal strengths in focus groups and interviews that fit into three categories:

• Personal attributes, such as having a positive attitude
• Interpersonal relationships, such as having support from family or friends
• Access to community resources, such as knowing where to go when one has a health problem

The design team identified scenarios in which a strengths-based approach might be particularly helpful for patients. Examples included managing diabetes, managing chronic pain, and when patients frequently use health care.

Limitations

The research team tested the app only with patients who were members of the design team. As a result, the research did not demonstrate the usefulness of the app for other patients. The team also was not able to see if using patient strengths improved patient health.

Conclusions and Relevance

Patients could use the app to identify and prioritize personal strengths that may be useful in talking to healthcare providers about how to manage their chronic conditions.

Future Research Needs

Future research could determine if patients and clinicians can use the app beneficially in real-world clinical settings. Additional studies could also examine whether strengths-based care improves patient health outcomes.