Abstract
Behavioral health costs have continued to escalate in the United States, with 36.2 million Americans paying a total of $57.5 billion in 2006 for behavioral health services (National Institute of Mental Health (2006) Mental healthcare cost data for all Americans (2006). Retrieved from National Institute of Menal Health. https://www.nimh.nih.gov/health/statistics/cost/mental-healthcare-cost-data-for-all-americans-2006.shtml). This increased expense has led to the proposal of a number of possible solutions to reign in the escalating cost of both medical and behavioral health treatments. Among these proposals are three important, and what will be argued interrelated, concepts: behavioral health literacy, shared decision-making, and patient-centered care. While these constructs are frequently mentioned as possible avenues to reduce healthcare costs and generally improve the quality and experience of care, the terms themselves are ill-defined, and consequently poorly measured, and inconsistently implemented. Despite the lack of agreed-upon definitions, several methods of defining and measuring these three constructs have been developed, but it raises the question about what these constructs and measures are capturing.
What follows is a critical review of the existing definitions of each construct, with the intent of developing a more useful, adequate definition for each construct. Additionally, methods of adapting each construct to behavioral health applications will be proposed. Finally, guidelines of how an integrated construct comprising of the three constructs might be implemented in the behavioral health setting will be presented.
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Notes
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It should be noted that this definition applies to the provider as well as the patient. Specifically, the provider should have access to the necessary information to help their patients become literate in behavioral health concerns or know where to find said information.
References
Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs AMA. (1999). Health literacy: Report of the council on scientific affairs. Journal of the American Medical Association, 552–557.
Adams, J. R., Drake, R. E., & Wolford, G. L. (2007). Shared decision-making preferences of people with severe mental illness. Psychiatric Services, 58(9), 1219–1221.
Adams, R. J., Stocks, N. P., Wilson, D. H., Hill, C. L., Gravier, S., Kickbusch, I., & Beilby, J. J. (2009). Health literacy: A new concept for general practice? Australian Family Physician, 38(3), 144.
Adkins, N. R., & Corus, C. (2009). Health literacy for improved health outcomes: Effective capital in the marketplace. Journal of Consumer Affairs, 43(2), 199–222.
Australian Board of Statistics. (2008). Adult literacy and life skills survey: Summary results. Canberra, Australia: Australian Bureau of Statistics.
Bertakis, K. D., & Azari, R. (2011). Patient-centered care is associated with decreased health care utilization. The Journal of the American Board of Family Medicine, 24(3), 229–239.
Calabretta, N. (2002). Consumer-driven, patient-centered health care in the age of electronic information. Journal of the Medical Library Association, 90(1), 32.
Centers for Medicare & Medicaid Services. (2015). Highlights. Retrieved from Centers for Medicare & Medicaid Services: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting Psychology, 66, 7–18.
Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social Science & Medicine, 44(5), 681–692.
Corbin, C. L., Kelley, S. W., & Schwartz, R. W. (2001). Concepts in service marketing for healthcare professionals. The American Journal of Surgery, 181(1), 1–7.
Dobscha, S. K., Cromer, R., Crain, A., & Denneson, L. M. (2016). Qualitative analysis of US Department of veterans affairs mental health clinician perspectives on patient-centered care. International Journal for Quality in Health Care, 28(3), 355–362.
Drake, R. E., Deegan, P. E., & Rapp, C. (2010). The promise of shared decision making in mental health. Psychiatric Rehabilitation Journal, 34, 7–13.
Duncan, I., Ahmed, T., Li, Q., Stetson, B., Ruggiero, L., Burton, K., … Fitzner, K. (2011). Assessing the value of the diabetes educator. The Diabetes Educator, 37(5), 638–657.
Elwyn, G., Edwards, A., Mowle, S., Wensing, M., Wilkinson, C., Kinnersley, P., & Grol, R. (2001). Measuring the involvement of patients in shared decision-making: a systematic review of instruments. Patient Education and Counseling, 43(1), 5–22.
Ende, J., Kazis, L., Ash, A., & Moskowitz, M. A. (1989). Measuring patients’ desire for autonomy. Journal of General Internal Medicine, 4(1), 23–30.
Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100–103 https://doi.org/10.1370/afm.1239
European Commission. (2007). Together for health: A strategic approach for the EU Commission of the European Communities: Brussels 2008–2013.
Freedman, D. A., Bess, K. D., Tucker, H. A., Boyd, D. L., Tuchman, A. M., & Wallston, K. A. (2009). Public health literacy defined. American Journal of Preventive Medicine, 36(5), 446–451.
Hamann, J., Cohen, R., Leucht, S., Busch, R., & Kissling, W. (2005). Do patients with schizophrenia wish to be involved in decisions about their medical treatment. American Journal of Psychiatry, 162, 2382–2384.
Ishikawa, H., & Yano, E. (2008). Patient health literacy and participation in the health‐care process. Health Expectations, 11(2), 113–122.
Jorm, A. F. (2012). Mental health literacy: empowering the community to take action for better mental health. American Psychologist, 67(3), 231.
Jorm, A. F., Jacomb, P., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182–186.
Kickbusch, I., & Nutbeam, D. (1998). Health promotion glossary. Geneva, Switzerland: World Health Organization.
Kickbusch, I., Wait, S., Maag, D., & Banks, I. (2006). Navigating health: The role of health literacy. London, UK: Alliance for Health and the Future, International Longevity Centre.
Levinson, W., Kao, A., Kuby, A., & Thisted, R. A. (2005). Not all patients want to participate in decision making. Journal of General Internal Medicine, 20(6), 531–535.
Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting patient-centered care: A qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience. International Journal for Quality in Health Care, 23, 510–515.
Makoul, G., & Clayman, M. L. (2006). An integrative model of shared decision making in medical encounters. Patient Education and Counseling, 60, 301–312.
Mancuso, J. M. (2008). Health literacy: A concept/dimensional analysis. Nursing & Health Sciences, 10(3), 248–255.
National Institute of Mental Health. (2006). Mental healthcare cost data for all Americans (2006). Retrieved from National Institute of Menal Health. https://www.nimh.nih.gov/health/statistics/cost/mental-healthcare-cost-data-for-all-americans-2006.shtml
Nezu, A. M., Nezu, C. M., & D’Zurilla, T. (2012). Problem-solving therapy: A treatment manual. New York, NY: Springer Publishing Company.
Nielsen-Bohlman, L. T., Panzer, A. M., Hamlin, B., & Kindig, D. A. (2004). Institute of Medicine. Health literacy: A prescription to end confusion. Committee on Health Literacy, Board on Neuroscience and Behavioral Health.
Nutbeam, D. (2000). Health literacy asa public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15, 259–267.
Paasche-Orlow, M. K., & Wolf, M. S. (2007). The causal pathways linking health literacy to health outcomes. American Journal of Health Behavior, 31(1), S19–S26.
Pavlekovic (Ed.). (2008). Health literacy: Programmes for training on reseach in public health for south eastern eurpoe (Vol. IV). Health Promotion and Disease Prevention.
President’s Commission for the Study of Ethical Problems in Medicine, Biomedical, & Behavioral Research (US). (1982). Making Health Care Decisions (Vol. 1). President’s Commission for the study of ethical problems in medicine and biomedical and behavioral research.
Rootman, I., & Gordon-El-Bihbety, D. (2008). A vision for a health literate Canada. Ottawa, ON: Canadian Public Health Association.
Simonds S.K. (1974). Health education as social policy. Health Education Monograph, 2, 1–25.
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12(1), 80.
Stewart, M., Brown, J. B., Donner, A., McWhinney, I. R., Oates, J., Weston, W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. The Journal of Family Practice, 49(9), 1–13.
Towle, A., & Godolphin, W. (1999). Framework for teaching and learning informed shared decision making. BMJ: British Medical Journal, 319(7212), 766.
Yost, K. J., Webster, K., Baker, D. W., Choi, S. W., Bode, R. K., & Hahn, E. A. (2009). Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testing. Patient Education and Counseling, 75(3), 295–301.
Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2003). Elaborating a definition of health literacy: A commentary. Journal of Health Communication, 8(S1), 119–120.
Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2005). Understanding health literacy: An expanded model. Health Promotion International, 20(2), 195–203.
Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2009). Advancing health literacy: A framework for understanding and action (Vol. 45). San Fransisco: Wiley.
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Willis, B., O’Donohue, W.T. (2018). The Neglected Constructs of Health Literacy, Shared Decision-Making, and Patient-Centered Care in Behavioral Health: An Integrated Model. In: Duckworth, M., O'Donohue, W. (eds) Behavioral Medicine and Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93003-9_8
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