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Patient Empowerment and Health Literacy: Model Validation and Communication Strategies for Improving Chronic Pain Management

Applicant Schulz Peter
Number 130030
Funding scheme Project funding (Div. I-III)
Research institution Istituto Media e Giornalismo Facoltà di Scienze della comunicazione Università della Svizzera italiana
Institution of higher education Università della Svizzera italiana - USI
Main discipline Communication sciences
Start/End 01.04.2010 - 31.01.2014
Approved amount 293'994.00
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Keywords (9)

health communication; health literacy; empowerment; health education; Chronic Pain Management; patient empowerment; chronic lower back pain; fibromyalgia; e-health

Lay Summary (English)

Lead
Lay summary
Kontext und Bedeutung des ProjektsHealth communications research has provided insights on the processes by which mass media and interpersonal communications influence individual and community decisions designed to enhance health. Considerable attention has been devoted to the improvement of health literacy and health empowerment as a route to improved health outcomes and quality-to-life. We propose a distinction between volitional empowerment (drawing on the analyses of psychological empowerment in the management literature) and a literacy component of empowerment built on our prior broadened conceptualization of health literacy, but we argue that these two factors are explicitly linked as aspects of health empowerment.Wissenschaftlicher Rahmen und MethodologieWe will conduct three studies to investigate the role and impact of health empowerment on the management of chronic pain. In our first study, we develop and validate measures of health empowerment (both volitional and literacy components) and test the validity of our empowerment schema in the Swiss-French and Swiss-Italian regions of Switzerland. Our second study examines the implications of patient empowerment for chronic pain patients. We will study 250 patients in the Swiss-French and Swiss-Italian regions of Switzerland, collect the requisite empowerment measures as well as behavioral measures with respect to pain management and the use and possible misuse of prescription pain medications. We expect that low volitional empowerment and low literacy can both lead (through different mechanisms) to both destructive behaviors and medication misuse. For our third study, we will develop an intervention to increase literacy and volitional empowerment relative to self-management of chronic pain. We will compare the effectiveness of a literacy-oriented intervention alone and one involving both literacy and volitional empowerment interventions. The volitional empowerment intervention will be modeled on a successful website program developed previously by the investigator for the SNF-funded project ONESELF.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Adapting Health Communication to Individuals‘ Health Literacy
Frisch A.L. (2011), Adapting Health Communication to Individuals‘ Health Literacy, in Studies in Communication Sciences, 11, 71-83.
Defining and Measuring Health Literacy: How can we profit from other literacy domains?
Frisch A. L., Camerini L, Diviani N, Schulz P.J., Defining and Measuring Health Literacy: How can we profit from other literacy domains?, in Health Promotion International.
Multivariate determinants of self-management in health care: Assessing Health Empowerment Model by comparison between structural equation and graphical models approaches
Trentini F, Multivariate determinants of self-management in health care: Assessing Health Empowerment Model by comparison between structural equation and graphical models approaches, in SAGE Open.

Collaboration

Group / person Country
Types of collaboration
League of Rheumatologists, Ticino Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Multidisciplinary Pain Center, University Hospital of Geneva Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Association of Physiotherapists, Ticino Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Pain Center and Center for Neurosurgery, Regional Hospital of Ticino Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
International Conference on Communication in Healthcare organized by the European Association of Communication in Healthcare (EACH) Individual talk Health literacy: Conceptualization, measurement, and its role in health communication. 04.05.2012 St. Andrews, Scotland, Great Britain and Northern Ireland Schulz Peter; Camerini Anne-Linda;
International Conference on Communication in Healthcare (EACH) Poster The role of health literacy in psychological empowerment of patients with chronic low back pain: Results from a cross-sectional study in Switzerland. 04.05.2012 St. Andrews, Scotland, Great Britain and Northern Ireland Camerini Anne-Linda; Schulz Peter;
12th Kentucky Conference on Health Communication: Health Literacy Research and Practice Individual talk Health literacy and patient empowerment: Results from a cross-sectional survey with chronic low back pain patients in Switzerland. 20.04.2012 Kentucky, USA, United States of America Camerini Anne-Linda; Schulz Peter;
61st Annual ICA Conference organized by the International Communication Association Individual talk Predictors, mediators and moderators of psychological empowerment: Results from a cross-sectional study with chronic low back pain patients in Switzerland 26.05.2010 Boston, USA, United States of America Schulz Peter; Camerini Anne-Linda;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Colloquium Communication & Health: Research on New Topics organized by the Institute of Communication and Health 24.11.2011 Lugano, Switzerland Camerini Anne-Linda;


Associated projects

Number Title Start Funding scheme
147333 “Bad” Literacy, Health Empowerment, and the Problem of Vaccination Refusal 01.07.2013 Project funding (Div. I-III)

Abstract

Health communications research has provided significant insights on the processes by which both mass media and interpersonal communications inform and influence individual and community decisions designed to enhance health. In recent years, considerable attention has been devoted to the application of health communication to the improvement of health literacy and health empowerment as a route to improved health outcomes and quality-fo-life. The goal of this project is to develop a clearer understanding of patient empowerment, its relationship to health literacy, and its impact on health decision-making, behavior, and outcomes in the spe-cific context of the management of chronic pain. Health empowerment focuses on the importance of autonomous action by the patient serving his or her own health interests (rather than on compliance with directives from healthcare pro-fessionals). However, varied perspectives-from medical to political-have been applied to the concept of empowerment. We first explicate more fully our conceptualization of empowerment in the health domain. Many views of health empowerment, focusing on independence, consider only implicitly the knowledge requirements for patients to make informed decisions. We propose a distinction between volitional empowerment (drawing on the analyses of psychological empo-werment in the management literature) and a literacy component of empowerment built on our prior broadened conceptualization of health literacy (Peter J. Schulz & Kent Nakamoto, 2005) but we argue that these two factors are explicitly linked as aspects of health empowerment. Considering empowerment in the health communication process, specifically within a doctor-patient context, involves the patient not as a passive recipient of information whose task is mere comprehension and acceptance but as an active processor of information extracting self-relevant meaning from proffered information and advice (from healthcare professionals) and choosing and enacting behaviors he or she believes appropriate to the health situation. In our project, we develop three studies to investigate the role and impact of health empowerment on the management of chronic pain. In our first study, we develop and validate measures of health empowerment (both volitional and literacy components) and test the nomological validity of our empowerment schema which implicates these constructs in health decisions and behaviors. Our validation study will seek to test the schema in two linguistic regions of Switzerland (Swiss-French and Swiss-Italian).Our second study examines the implications of patient empowerment for chronic pain patients. We will study 250 patients in the Swiss-French and Swiss-Italian regions of Switzerland suffer-ing from chronic pain and in the care of a physician. Using computer-aided surveys, we will collect the requisite empowerment measures as well as behavioral measures with respect to pain management and the use and possible misuse of prescription pain medications. This latter is a problem that has begun to assume significant visibility in the United States and we believe, warrants investigation in the Swiss context. We expect that low volitional empowerment and low literacy can both lead (through different mechanisms) to both destructive behaviors and medication misuse.For our third study, we will develop an intervention to increase literacy and volitional empo-werment relative to self-management of chronic pain. We will compare the effectiveness of a literacy-oriented intervention alone and one involving both literacy and volitional empowerment interventions. The volitional empowerment intervention will be modeled on a successful website program developed by the primary investigator for the SNF-funded project ONESELF which focused on improved management of chronic low back pain. We hypothesize that the combined empowerment interventions, coupled with physician reinforcement, will improve patients’ ability to effectively and constructively manage their chronic pain and improve their health outcomes and quality-of-life.Our project is significant in that we propose an expanded but structured conceptualization of health empowerment. We then use this conceptualization to study the problem of managing chronic pain and to further the rational development of pain management and health promotion programs.
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