Online Program

Patient activation: Microdemocracy at work in the community

Tuesday, November 5, 2013 : 4:50 p.m. - 5:10 p.m.

Darwin Deen, MD, MS, Community Health and Social Medicine, Sophie Davis School of Biomedical Education, New York, NY
Marthe Gold, MD, MPH, Community Health and Social Medicine, Sophie Davis School of Biomedical Education, New York, NY
Rebecca Howe, BA, The Right Question Institute, Cambridge, MA
Microdemocracy seeks to help individuals participate effectively in decisions that affect them in encounters with public agencies. In health care this takes the form of patient activation which reflects the belief that one's behaviors are important contributors to health outcomes. Underrepresented minority and lower socioeconomic status (SES) individuals have lower levels of activation which may contribute to disparities. Physicians communicate less collaboratively with patients who ask fewer questions thus teaching patients to ask questions may improve communication and help address disparities. We developed a brief intervention designed to help patients prepare for their visit with a health care provider and to reinforce the message that their participation is necessary for quality health care. We have trained medical students learn to deliver this intervention in Patient-Centered Medical Homes in New York City. Students receive a single workshop as part of their interviewing skills curriculum and the interventions are “service learning,” a contribution that they make to show appreciation for the sites and patients that contribute to their education. We have demonstrated that students who participate understand patient-centered interviewing better. Students approach patients in the waiting room, helping them to use otherwise unproductive time and generate a prioritized list of 3 questions to be discussed during their health care encounter. Patients learn to distinguish between open and closed ended questions and the type of information the answers to each will generate. We will describe the intervention, the training model, and discuss the differential effects of the intervention in language discordant physician-patient relationships.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Communication and informatics
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health

Learning Objectives:
Describe a new patient activation intervention Discuss the relationship of patient activation in the microdemocracy model Propose a model for engaging medical students in addressing health disparities

Keyword(s): Access and Services, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As the Patient Engagement Fellow with the Right Question Institute, I have a strong understanding of the Right Question strategy that was taught to patients by medical students at the Sophie Davis School of Biomedical Education. I also designed and conducted a qualitative research study using the Right Question strategy in a community health center.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.