Abstract
Objective: This paper examines how and why to improve care systems for disease management and health promotion for the growing population of cancer survivors with cardiovascular multi-morbidities. Method: We reviewed research characterizing cancer survivors' and their multiple providers' common sense cognitive models of survivors' main health threats, preventable causes of adverse health events, and optimal coping strategies. Results: Findings indicate that no entity in the health care system selfidentifies as claiming primary responsibility to address longstanding unhealthy lifestyle behaviors that heighten survivors' susceptibility to both cancer and cardiovascular disease (CVD) and whose improvement could enhance quality of life. Conclusions: To address this gap, we propose systems-level changes that integrate health promotion into existing survivorship services by including behavioral risk factor vital signs in the electronic medical record, with default proactive referral to a health promotionist (a paraprofessional coach adept with mobile technologies and supervised by a professional expert in health behavior change). By using the patient's digital tracking data to coach remotely and periodically report progress to providers, the health promotionist closes a gap, creating a connected care system that supports, reinforces, and maintains accountability for healthy lifestyle improvement. No comparable resource solely dedicated to treatment of chronic disease risk behaviors (smoking, obesity, physical inactivity, treatment nonadherence) exists in current models of integrated care. Integrating health promotionists into care delivery channels would remove burden from overtaxed PCPs and instantiate a comprehensive, actionable systems-level schema of health risks and coping strategies needed to have preventive impact with minimal interference to clinical work flow.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 840-850 |
| Number of pages | 11 |
| Journal | Health Psychology |
| Volume | 38 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2019 |
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Keywords
- Cancer survivors
- Electronic health records
- Health behavior
- Health promotion
- Risk factors
ASJC Scopus subject areas
- Applied Psychology
- Psychiatry and Mental health
Cite this
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Toward a health-promoting system for cancer survivors : Patient and provider multiple behavior change. / Spring, Bonnie; Stump, Tammy; Penedo, Frank; Pfammatter, Angela Fidler; Robinson, June K.
In: Health Psychology, Vol. 38, No. 9, 09.2019, p. 840-850.Research output: Contribution to journal › Article
TY - JOUR
T1 - Toward a health-promoting system for cancer survivors
T2 - Patient and provider multiple behavior change
AU - Spring, Bonnie
AU - Stump, Tammy
AU - Penedo, Frank
AU - Pfammatter, Angela Fidler
AU - Robinson, June K.
PY - 2019/9
Y1 - 2019/9
N2 - Objective: This paper examines how and why to improve care systems for disease management and health promotion for the growing population of cancer survivors with cardiovascular multi-morbidities. Method: We reviewed research characterizing cancer survivors' and their multiple providers' common sense cognitive models of survivors' main health threats, preventable causes of adverse health events, and optimal coping strategies. Results: Findings indicate that no entity in the health care system selfidentifies as claiming primary responsibility to address longstanding unhealthy lifestyle behaviors that heighten survivors' susceptibility to both cancer and cardiovascular disease (CVD) and whose improvement could enhance quality of life. Conclusions: To address this gap, we propose systems-level changes that integrate health promotion into existing survivorship services by including behavioral risk factor vital signs in the electronic medical record, with default proactive referral to a health promotionist (a paraprofessional coach adept with mobile technologies and supervised by a professional expert in health behavior change). By using the patient's digital tracking data to coach remotely and periodically report progress to providers, the health promotionist closes a gap, creating a connected care system that supports, reinforces, and maintains accountability for healthy lifestyle improvement. No comparable resource solely dedicated to treatment of chronic disease risk behaviors (smoking, obesity, physical inactivity, treatment nonadherence) exists in current models of integrated care. Integrating health promotionists into care delivery channels would remove burden from overtaxed PCPs and instantiate a comprehensive, actionable systems-level schema of health risks and coping strategies needed to have preventive impact with minimal interference to clinical work flow.
AB - Objective: This paper examines how and why to improve care systems for disease management and health promotion for the growing population of cancer survivors with cardiovascular multi-morbidities. Method: We reviewed research characterizing cancer survivors' and their multiple providers' common sense cognitive models of survivors' main health threats, preventable causes of adverse health events, and optimal coping strategies. Results: Findings indicate that no entity in the health care system selfidentifies as claiming primary responsibility to address longstanding unhealthy lifestyle behaviors that heighten survivors' susceptibility to both cancer and cardiovascular disease (CVD) and whose improvement could enhance quality of life. Conclusions: To address this gap, we propose systems-level changes that integrate health promotion into existing survivorship services by including behavioral risk factor vital signs in the electronic medical record, with default proactive referral to a health promotionist (a paraprofessional coach adept with mobile technologies and supervised by a professional expert in health behavior change). By using the patient's digital tracking data to coach remotely and periodically report progress to providers, the health promotionist closes a gap, creating a connected care system that supports, reinforces, and maintains accountability for healthy lifestyle improvement. No comparable resource solely dedicated to treatment of chronic disease risk behaviors (smoking, obesity, physical inactivity, treatment nonadherence) exists in current models of integrated care. Integrating health promotionists into care delivery channels would remove burden from overtaxed PCPs and instantiate a comprehensive, actionable systems-level schema of health risks and coping strategies needed to have preventive impact with minimal interference to clinical work flow.
KW - Cancer survivors
KW - Electronic health records
KW - Health behavior
KW - Health promotion
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85071265433&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071265433&partnerID=8YFLogxK
U2 - 10.1037/hea0000760
DO - 10.1037/hea0000760
M3 - Article
C2 - 31436465
AN - SCOPUS:85071265433
VL - 38
SP - 840
EP - 850
JO - Health Psychology
JF - Health Psychology
SN - 0278-6133
IS - 9
ER -