Factors that facilitate patient activation in the self-management of diabetes and depression among participants enrolled in an integrated chronic care model in India

• Type of Material: Article
• Authors: Leslie Johnson, Emory University; Nancy Thompson, Emory University; Mohammed Ali, Emory University; Nikhil Tandon, All India Institute of Medical Sciences; Lydia Chwastiak, University of Washington; Viswanathan Mohan, Madras Diabetes Research Foundation
• Language: English
• Date: 2021-01-21
• Publisher: Pergamon Elsevier Science Ltd.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2020.113646
• Title of Journal or Parent Work: Social Science and Medicine
• Volume: 270
• Start Page: 113646
• End Page: 113646
• Keywords: Social Sciences, Biomedical; Behavioral intervention; Asia; Life Sciences & Biomedicine; Science & Technology; Coordinated care; Social Sciences; Public, Environmental & Occupational Health; Realist evaluation; Low-resource; Biomedical Social Sciences
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Occupational Health and Safety; Engineering, Biomedical

Abstract

Background: The aim of this study was to identify factors that influence patients’ motivation and ability to self-manage their diabetes and depressive symptoms. Methods: From 2016 to 17, in-depth interviews were conducted with 62 patients receiving the INDEPENDENT care model across two clinics in India. Using a realist evaluation approach, a hypothesized program theory for patient activation was tested and refined. Findings: The refined theory demonstrates that motivation, education, and engagement cumulatively contribute to patient activation. Conclusion: The results indicate that positive and sustained patient-provider relationships drive patient motivation and enhance implementation of the care model.