Exploring Contextual Factors and Patient Activation: Evidence from a Nationally Representative Sample of Patients with Depression

Autor/inn/en	Chen, Jie; Mortensen, Karoline; Bloodworth, Robin
Titel	Exploring Contextual Factors and Patient Activation: Evidence from a Nationally Representative Sample of Patients with Depression
Quelle	In: Health Education & Behavior, 41 (2014) 6, S.614-624 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1090-1981
DOI	10.1177/1090198114531781
Schlagwörter	Patients; Depression (Psychology); Mental Health; Health Services; Mental Disorders; Comorbidity; Correlation; Foreign Nationals; Clinics; Hospitals; Primary Health Care; Physician Patient Relationship; Intervention; Low Income; Immigrants; Community Characteristics; Context Effect; Clinical Diagnosis; Surveys + Suchen Sie Ihr Suchwort? Patient; Psychohygiene; Health service; Gesundheitsdienst; Gesundheitswesen; Mental illness; Geisteskrankheit; Korrelation; Ausländer; Ausländerin; Krankengymnast; Krankenhaus; Gesundheitsvorsorge; Arzt-Patient-Beziehung; Niedriglohn; Immigrant; Immigrantin; Immigranten; Survey; Umfrage; Befragung
Abstract	Patient activation has been considered as a "blockbuster drug of the century." Patients with mental disorders are less activated compared to patients with other chronic diseases. Low activation due to mental disorders can affect the efficiency of treatment of other comorbidities. Contextual factors are significantly associated with mental health care access and utilization. However, evidence of their association with patient activation is still lacking. Using data from the Health Tracking Household Survey 2007 and Area Health Resource File 2008, we examine the association between contextual factors and self-reported activation levels among patients with depression. We investigate two types of contextual factors--(a) site of usual source of care and (b) community characteristics, measured by mental health care resources availability, population demographics, and socioeconomic characteristics at the county level. Results show significant variation in activation levels by contextual factors. The availability of community mental health centers, lower proportion of foreign-born individuals, and higher income in the local community are associated with higher patient activation. Our results also show that depressed patients having a usual source of care at a physician's office have significantly higher patient activation levels than those with a usual source of care in the emergency department or hospital outpatient clinics. Results suggest that primary care setting is critical to having a sustained relationship between patients and physicians in order to enhance patient engagement in mental health care. Interventions in communities with low income and high immigrant populations are necessary. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10