Talking the patient's language: Changing behavior for the future
Christopher Kelly, MEd
Blog
Jan 18, 2018

Understanding the barriers and looking at behavior change models can help healthcare professionals and biopharma companies understand, predict and change patient behavior through knowledge, attitudes and beliefs, and skills.

Changing patients' behavior, particularly where lifestyle and treatment adherence are concerned, can have a positive impact on disease outcomes. However, changing behavior is difficult. This can, at least in part, be ascribed to 4 psychological barriers to behavior change: 

  • Trivialization or denial – either denying that a problem is serious, or deciding that the risk is so small that change isn't worth it
  • Perceived invulnerability – it won't happen to me
  • Faulty conceptualization – attributing symptoms to something non-serious, or misconceptions about symptoms/causes
  • Debilitating emotions – being too afraid to seek help, or avoiding thinking about the condition

Understanding the barriers and looking at behavior change models can help healthcare professionals and biopharma companies understand, predict and change patient behavior through knowledge, attitudes and beliefs, and skills.

Looking to the literature: The impact of negative beliefs

Studies have shown that negative beliefs can influence treatment outcomes. In an analysis of patients with spine pain, lower self-efficacy was negatively associated with more perceived disability in low back pain. “Less positive expectations” was linked with more perceived disability in neck pain. Patients with a lower positive expectation were less likely to have a clinical meaningful change in lower back pain. 

Negative beliefs about medications also have an impact on adherence, and therefore on outcomes. In a sample of patients at the Mount Sinai Department of Family Medicine in New York, NY those patients with negative beliefs were 49% less likely to take their medications properly than those with positive beliefs. This impact was greater than other barriers to access, including cost, access to refills, and perceived side effects.

Using the biopsychosocial assessment model

The biosocial model looks at the needs, drivers and barriers of patients and caregivers from a holistic perspective. The model identifies who they are and how the biological, psychological, social and cultural factors around them change how they react to the condition and its treatment.

The model shows the division of impact across different areas of a patient’s life. Clearly, different conditions and their treatments will have differing impacts on the various areas within the model, and some patients may have better coping strategies than others with the same condition. The biopsychosocial assessment model provides a framework for understanding patient support and resource needs. 

The digital element

Digital engagement programs that take into consideration the patients' and caregivers' needs, drivers and barriers can play an important role in changing patients’ behavior. The real-time feedback and robust analytics, for example seeing what people are looking for, which tools they use and how, or how they respond to survey questions, means that the programs can be tailored and personalized to patients' needs.

The “always on” nature of a digital support program, particularly where it is reinforced by HCP-led care, can help to create longer-lasting behavior change as patients return to see new content or to revisit old content. 

What the professionals say

In a recent webinar, we asked participants "How well trained is your organization in health literacy and patient engagement?" More than 40% indicated they had some training, which shows an awareness of the importance of this area, but still a gap for greater education for healthcare professionals.

From the patient's perspective 

In the webinar Keith and Judy, both caregivers for immediate family, explained that education has a big impact on health behavior. However, they urge healthcare professionals and companies to remember that caregivers can be under a lot of stress and pressure and may not “get it” the first time. Their advice was to show caregivers the tools and support, and the impact of behavior change, and allow them to ask questions to ensure they understand the recommendations.
While it is important that patients and caregivers understand what could happen if they don’t adhere to their treatment plan, it's essential to approach the subject carefully and avoid causing fear. 
Effectively changing patient behavior is based around developing tools and techniques that touch all stakeholders and work with all learning styles.

To learn more about how to speak the patients' language, please watch the on-demand webinar (registration required). 

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