The Science and Psychology behind Patient Engagement

Michael Brzozowski is EVP and managing director of patient engagement for McCann Health North America.
Michael Brzozowski is EVP and managing director of patient engagement for McCann Health North America.

Patient engagement continues to be one of the hottest topics in the industry. However, most discussions seem to focus only on exciting new digital and mobile technologies that are empowering patients to manage their health and revolutionizing the ways they can do it. But technology is just one part of the complex process of patient engagement.

Where are the discussions about applying proven behavior change models or the principles of adult learning and health literacy? Studies have shown that patients of all literacy levels forget key information provided to them during doctor visits, sometimes within minutes! Low health literacy can create dangerous situations and even highly educated patients can be affected, particularly if they are sick. Therefore, a critical factor to successful patient engagement is the ability to develop patient education materials that are not only understandable, but are also appealing, relevant, and easy to act on.

Mapping the Patient Experience

So, where do you start? The first step is to map the patient experience and then use specific research techniques to understand patient motivations and barriers to achieving better health at each, different stage of their healthcare experience. It's important to supplement traditional qualitative and quantitative methodologies with more insight-driven techniques such as ethnography, social listening, and social science literature reviews to get to the heart of patients' motivations and barriers to achieving better health. 

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Only when we understand the emotions behind a patient's decision-making can engaging and effective communications be developed. This process leads to a deeper understanding of the core emotional truths that can be leveraged to change behavior and the key inflection points that matter most along the patient's experience.    

Identifying the Best Behavior Change Model

After gathering and synthesizing all the insights into an experience map, the next step is to identify the behavior change model and framework that best applies to that condition.

Often multiple models are used at different points in the patient experience. For example, in the osteoporosis category, the Health Belief Model, a psychological model that can predict health behavior, provides a useful framework during the awareness and education phase of the patient experience. The fundamental challenge for older women during this phase is do they truly believe their health is at risk? Have they gotten a bone scan and thus a diagnosis? When she has already seen the doctor and gotten her medication we no longer need to convince her that osteoporosis is important.

See also: No More 'Patient-Centric,' Please

The next behavioral challenge is ensuring that she takes her medication to prevent further deterioration and life-limiting injuries in the future. The Model of Adherence, developed by Rob Horne, provides a highly effective construct for structuring content to ensure that she recognizes the risks and benefits of taking medication to treat her osteoporosis. Behavior models provide a foundation to build content strategies for each phase of the patient experience. When done right, patient education materials can change patient behavior and lead to better health outcomes.   

Improving Health Literacy

A comprehensive examination of hundreds of patient education materials across dozens of disease states from multiple healthcare ecosystem players, including pharma companies, resulted in significant issues. Either the materials were too scientific and complex; or they had dense blocks of copy; or “legalese” gets printed unchanged; or there is little or no cultural literacy; or mathematical concepts like dosing and the risk of side effects are poorly explained.

We follow a simple framework that systematically assesses if patient materials are appealing, relevant, usable, learnable, and easy to act on. It may seem like commonsense but, surprisingly, an overwhelming amount of patient education materials do not follow these basic guidelines.  

By the year 2020, more than 157 million people will have chronic diseases and will be seeking ways to improve their personal healthcare decision-making process. At the same time, healthcare providers and pharma companies will be looking to engage these patients more effectively by increasing awareness of new products, helping people use those products correctly, and supporting patients as they manage their diseases. By applying the core principles of behavioral science, adult learning and health literacy it's possible to create an effective roadmap to meaningful patient engagement.   

Michael Brzozowski is EVP and managing director of patient engagement for McCann Health North America.