Results Summary

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.

Final Research Report

View this project's final research report.

Journal Citations

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also confirms that the research has followed PCORI’s Methodology Standards. During peer review, experts who were not members of the research team read a draft report of the research. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. Reviewers do not have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve how the research team analyzed its results or reported its conclusions. Learn more about PCORI’s peer-review process here.

In response to peer review, the PI made changes including

  • Providing additional clarity about the unique roles of academic and community partners. Responding to reviewer questions about the membership in the Design Team and its differentiation from the research team, the researchers emphasized the participatory approaches used to make sure that everyone contributed to most aspects of the study.
  • Describing how the researchers made sure that members of the Design Team represented certain segments of their target population. The researchers indicated that patient stakeholders were recruited from safety net practice settings that focus on care for disadvantaged populations, in response to reviewers’ questions about representation of individuals from disadvantaged groups.
  • Explaining that the researchers were not able to achieve Objective 4 of the study, which was to quantitatively model outcomes of the strengths-based approach, because of the limited published data on patient-oriented outcomes from a strengths-based approach.
  • Clarifying for reviewers that this study was not meant to be hypothesis testing or based on formal experiments. Instead, the researchers aimed to convey the iterative nature of the tool development undertaken in the project by showing how one study objective led to the next.

Conflict of Interest Disclosures

Project Information

Kurt C. Stange, MD, PhD
Case Western Reserve University
Patient-Identified Personal Strengths (PIPS) vs. Deficit-Focused Models of Care

Key Dates

December 2012
January 2018

Study Registration Information


Has Results
Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 11, 2024