Improving population health one person at a time? Accountable care organisations: perceptions of population health--a qualitative interview study.
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SUBMITTER: Noble DJ
PROVIDER: S-EPMC4010822 | biostudies-other | 2014 Apr
REPOSITORIES: biostudies-other
Publications
Improving population health one person at a time? Accountable care organisations: perceptions of population health--a qualitative interview study.
Noble Douglas J DJ Greenhalgh Trisha T Casalino Lawrence P LP
BMJ open 20140425 4
<h4>Objective</h4>This qualitative interview study explored perceptions of the phrases 'population health', 'public health' and 'community health'.<h4>Setting</h4>Accountable care organisations (ACOs), and public health or similar agencies in different parts of the USA.<h4>Participants</h4>Purposive sample of 29 interviewees at four ACOs, and 10 interviewees at six public health or similar agencies.<h4>Results</h4>Interviewees working for ACOs most often viewed 'population health' as referring t ...[more]
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Project description:BackgroundDigital health devices, such as health and well-being smartphone apps, could offer an accessible and cost-effective way to deliver health and well-being interventions. A key component of the effectiveness of health and well-being apps is user engagement. However, engagement with health and well-being apps is typically poor. Previous studies have identified a list of factors that could influence engagement; however, most of these studies were conducted on a particular population or for an app targeting a particular behavior. An understanding of the factors that influence engagement with a wide range of health and well-being apps can inform the design and the development of more engaging apps in general.ObjectiveThe aim of this study is to explore user experiences of and reasons for engaging and not engaging with a wide range of health and well-being apps.MethodsA sample of adults in the United Kingdom (N=17) interested in using a health or well-being app participated in a semistructured interview to explore experiences of engaging and not engaging with these apps. Participants were recruited via social media platforms. Data were analyzed with the framework approach, informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework, which are 2 widely used frameworks that incorporate a comprehensive set of behavioral influences.ResultsFactors that influence the capability of participants included available user guidance, statistical and health information, reduced cognitive load, well-designed reminders, self-monitoring features, features that help establish a routine, features that offer a safety net, and stepping-stone app characteristics. Tailoring, peer support, and embedded professional support were identified as important factors that enhance user opportunities for engagement with health and well-being apps. Feedback, rewards, encouragement, goal setting, action planning, self-confidence, and commitment were judged to be the motivation factors that affect engagement with health and well-being apps.ConclusionsMultiple factors were identified across all components of the COM-B model that may be valuable for the development of more engaging health and well-being apps. Engagement appears to be influenced primarily by features that provide user guidance, promote minimal cognitive load, support self-monitoring (capability), provide embedded social support (opportunity), and provide goal setting with action planning (motivation). This research provides recommendations for policy makers, industry, health care providers, and app developers for increasing effective engagement.
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