Abstract
The shift in patterns of disease toward chronic illness necessitates greater patient participation in its management and in their own rehabilitation, and they require greater social support over longer peiods. Patient activation, or the enhancement of patient and support group involvement in personal health care through teaching management techniques and problem-solving skills, has emerged in health education in response to this need. This paper will examine combined educational and behavioral approaches to increasing social support and patient activation in hypertension management. Activation in this study involves increased feelings of personal control over the contingencies surrounding the management of medical regimens. Both family support intervention and small group sessions oriented to changing compliance behavior by changing expectancy frames were offered to a randomized sample of 200 inner city, black, hypertensive patients who were part of a larger study. Patients were examined within a pretest—posttest randomized factorial design on measures of locus of control, belief in seriousness, efficacy of treatment, medication compliance, and blood pressure control. This combined approach showed small differences on the attitude and behavioral measures but displayed a significant effect on the program outcome variableblood pressure control (62% in control among intervention groups versus 46% in nonintervention groups).
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Additional information
Dr. Morisky is with the Johns Hopkins University Division of Health Education and Health Services Research and Development Center, 624 North Broadway, Baltimore, Maryland 21205; Dr. Bowler is with the George Mason University, Fairfax, Virginia; and Dr. Finlay is with the Agency for International Development, Washington, D.C..
This work was supported by NHLBI grant numbers 1R25 HL 17016-10, and 1T32 HL 07180, Lawrence W. Green and David M. Levine, co-principal investigators, and Sigrid Deeds, project coordinator, and NHLBI HV 1-72986. The authors wish to acknowledge the help of Carol Johns, Patterson Russell, Joan Wolle, Judy Chwalow, Christine Lewis, Lorraine Midanick, Sam Shapiro, Lee Bone, and Marion Field Fass. Portions of this paper were presented at the 1979 National Conference on High Blood Pressure Control, Washington, D.C., April 4–6, 1979.
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Morisky, D.E., Bowler, M.H. & Finlay, J.S. An educational and behavioral approach toward increasing patient activation in hypertension management. J Community Health 7, 171–182 (1982). https://doi.org/10.1007/BF01325513
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DOI: https://doi.org/10.1007/BF01325513