Evaluation of a patient activation and empowerment intervention in mental health care

Publication information:

Margarita Alegría, Antonio Polo, Shan Gao, Luz Santana, Dan Rothstein, Aida Jimenez, Mary Lyons Hunter, Frances Mendieta, Vanessa Oddo, and Sharon-Lise Normand. 2008. “Evaluation of a Patient Activation and Empowerment Intervention in Mental Health Care”. Med Care, 46, 3, Pp. 247-56. doi:10.1097/MLR.0b013e318158af52

Abstract

BACKGROUND: Evidence suggests that minority populations have lower levels of attendance and retention in mental health care than non-Latino whites. Patient activation and empowerment interventions may be effective in increasing minority patients' attendance and retention.OBJECTIVES: This study developed and evaluated a patient self-reported activation and empowerment strategy in mental health care.RESEARCH DESIGN: The Right Question Project-Mental Health (RQP-MH) trainings consisted of 3 individual sessions using a pre/post test comparison group design with patients from 2 community mental health clinics. The RQP-MH intervention taught participants to identify questions that would help them consider their role, process and reasons behind a decision; and empowerment strategies to better manage their care.SUBJECTS: A total of 231 participated, completing at least the pretest interview (n = 141 intervention site, 90 comparison site).MEASURES: Four main outcomes were linked to the intervention: changes in self-reported patient activation; changes in self-reported patient empowerment; treatment attendance; and retention in treatment.RESULTS: Findings show that intervention participants were over twice as likely to be retained in treatment and over 3 times more likely than comparison participants to have scheduled at least 1 visit during the 6-month follow-up period. Similarly, intervention participants demonstrated 29% more attendance to scheduled visits than comparison patients. There was no evidence of an effect on self-reported patient empowerment, only on self-reported patient activation.CONCLUSIONS: Results demonstrate the intervention's potential to increase self-reported patient activation, retention, and attendance in mental health care for minority populations. By facilitating patient-provider communication, the RQP-MH intervention may help minorities effectively participate in mental health care.