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Learning About Patient Engagement

By: Rosa Rios

Patient engagement is about empowering patients to take care of their health, but that’s not all. Patient engagement combines interventions to promote activation, self-care, positive health behavior, and wellness. Patient engagement is not always a conscious process. It requires a subconscious change in thoughts to create new healthy habits. We learned about thought processes in more detail in class. Doctor Thomas Morrow taught us about the brain’s response to behavioral change, and competence stages.

Behaviors and Habits

Behavior and actions are outcomes of attitudes and beliefs. Beliefs are constructed based on cultural background, education, and parental role modeling, among others. Beliefs and attitudes towards behavior change throughout the years, as an individual’s experience varies over time.  Beliefs are connected to habits, which are routine actions acquired over time. To create habits, individuals must continually reinforce their actions. For example, a patient who likes coffee first thing in the morning will put his medications near the coffee mug. The habit of drinking coffee will remind him to take his pills as soon as he sees his coffee mug.  As health communicators, we can use such behavioral cues to design more effective “nudges”. For example, electronic medication reminders can cue a behavior and prevent unconscious forgetting.

Competence Stages

It is important to bring up competence stages to understand the process of human behavior and habits. Competence is an individual’s mental and/or physical capacity to perform an action. The competence stages are divided into four categories:

  • First: The unconscious incompetence stage that is similar to a medical student making non-intentional mistakes. Medical students are in a process of information building that requires more brain energy and repetition of actions to reach the brain cortex memory levels.
  • The second stage is the conscious incompetent stage, which is similar to interns who know the material but have limited clinical experiences. In the conscious incompetent stage, the individual recognizes the need for action but has no idea how to perform the work.
  • The third stage is the conscious competent stage, which is similar to the medical resident that thinks about actions and understands how to perform those actions. Their thinking process is clear, and their action is the result of the activation of the thought processes in the brain cortex.
  • The fourth stage is the unconscious competent thinking process. In this stage, the individual behaves like a physician attending doing pure procedures from habit. An unconscious competent person performs an action based on brain impulses where thought processes are constructed as memories that react under rapid responses called reflex response. For example, a reflex response is to withdraw your finger rapidly from a hot stove or a needle. When humans learn and deeply internalized habits, these become unconscious reflexes that will only activate the primitive brain, saving energy for other newer forming memories in the brain cortex.

In the marketing world, some advertisements are tied to habits. This is part of the reason behind advertising success. Attaching health beliefs and health care to habits is one strategy to promote patient wellness. Doctor Morrow mentioned that patient engagement is the trending medical intervention to improve the health of Americans. Many health-marketing companies are learning more about patient engagement and behavioral change.

As health communication professionals, we will use patient engagement strategies to change behavior and persuade patients to better care for themselves.