Spotlight on the Patient Health Engagement model (PHE model): a psychosocial theory to understand people’s meaningful engagement in their own health care

Figures & data

Table 1 Main definitions of patient engagement currently available in the scientific literature

Author(s), year	Definitions of “patient engagement”
Hibbard et al, 2010^Citation19 (p.1918)	Patients’ motivation, knowledge, skills, and confidence to make effective decisions to manage their health
Gruman et al, 2010^Citation17 (p.353)	Set of behaviors including two overarching domains: 1) “managing health” behaviors, which is both the self-management of chronic disease and the adoption of healthy behaviors and 2) “managing health care” behaviors, which can be both patient and “consumeristic” behaviors
Carman et al, 2013^Citation1 (p.224)	Set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations, so that the desired goals of patient and family engagement include improving the quality and safety of health care
Graffigna et al, 2015^Citation71 (p.2)	Process-like and multidimensional experience resulting from the conjoint cognitive (think), emotional (feel), and conative (act) enactment of individuals toward their health management. In this process, patients go through four experiential positions (disengagement, arousal, adhesion, and eudaimonic project). The unachieved synergy among the different subjective dimensions (think, feel, act) at each stage of the process may inhibit patients’ ability to engage in their care
Légaré et al, 2013^Citation77 (p.277)	[“engagement” is] the process of individuals’ responsibilization that ensures that clear information leads to the best decision for the person who is seeking the care, thus improving self-management
Mittler et al, 2013^Citation78 (p.37)	Engaging consumers refers to the performance of specific behaviors (“engaged behaviors”) and/or an individual’s capacity and motivation to perform these behaviors (“activation”) aimed at gaining health
Forbat et al, 2009^Citation18 (p.84)	A range of ways to conceptualize involvement are used interchangeably in policy and practice without due recognition of the very different meanings of public consultation, patient/carer involvement in treatment decision making, and patient/carer involvement in service design and development

Figure 1 Description of the phases featuring the PHE model.

Abbreviation: PHE, Patient Health Engagement.

Figure 2 Description of the PHE-s: introduction and items.

Abbreviation: PHE-s, Patient Health Engagement scale.

HibbardJHMahoneyEToward a theory of patient and consumer activationPatient Educ Couns201078337738120188505

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GrumanJRovnerMHFrenchMEFrom patient education to patient engagement: implications for the field of patient educationPatient Educ Couns201078335035620202780

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CarmanKLDardessPMaurerMPatient and family engagement: a framework for understanding the elements and developing interventions and policiesHealth Aff (Millwood)20133222323123381514

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GraffignaGBarelloSBonanomiALozzaEMeasuring patient engagement: development and psychometric properties of the patient health engagement (PHE) scaleFront Psychol2015627425870566

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LégaréFWittemanHOShared decision making: examining key elements and barriers to adoption into routine clinical practiceHealth affairs201332227628423381520

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MittlerJNMartsolfGRTelenkoSJScanlonDPMaking sense of “consumer engagement” initiatives to improve health and health care: a conceptual framework to guide policy and practiceThe Milbank Quarterly2013911377723488711

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ForbatLCaylessSKnightingKCornwellJKearneyNEngaging patients in health care: an empirical study of the role of engagement on attitudes and actionPatient Educ Couns2009741849018790594

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