HealthDay News — Five key strategies are employed by clinicians to help promote patient behavior change, according to a study published in the Annals of Family Medicine.

Jessica Greene, PhD, from George Washington University in Washington, DC, and colleagues conducted a mixed methods study using data on the change in patient activation measure (PAM) score for 7144 patients. In-depth interviews were conducted with clinicians whose patients’ score increases were among the highest and among the lowest (10 of each).

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The researchers identified 5 strategies that were used among clinicians whose patients had relatively large activation increases to support patient behavior change: emphasizing patient ownership, partnering with patients, identifying small steps, scheduling frequent follow-up visits, and showing caring and concern for patients. 

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Clinicians whose patients had lesser change in activation were less likely to describe using these approaches (mean, 1.3 strategies versus 3.9 for clinicians whose patients had relatively large activation increases). Regardless of group, most clinicians reported developing their own approach to support patient behavior change. 

Compared with clinicians whose patients showed less improvement in activation, those whose patients showed high activation change reported spending more time with patients on counseling and education.

“The 5  key strategies used by clinicians with high patient activation change are promising approaches to supporting patient behavior change that should be tested in a larger sample of clinicians to validate their effectiveness,” the authors wote.

One author disclosed financial ties to Insignia Health.


Greene J, Hibbard J, Alvarez C, Overton V. Supporting Patient Behavior Change: Approaches Used by Primary Care Clinicians Whose Patients Have an Increase in Activation Levels. Ann Fam Med. 2016;14(2):148-154. doi:10.1370/afm.1904.