The Design and Testing of the Psychometric Properties of the Adolescent Capacity to Engage Index Instrument to Measure an Adolescent's Capacity to Engage in Healthcare.

Background and Purpose: Engagement in one's healthcare is paramount to improving health outcomes. As adolescents begin their journey into adulthood and increase involvement in their health-care decision-making, it is critical to understand their ability to be involved in their healthcare. The purpose of this instrumentation study was to develop and evaluate the psychometric properties and underlying factors of the Adolescent Capacity to Engage Index (ACEI) tool which measures the construct of an adolescent's capacity to engage in their healthcare. Methods: This study had a two-phase approach. Phase 1 consisted of the pilot and cognitive testing of the items developed based on the literature and content expertise. Phase 2 was the testing of the final 21 item revised instrument among 15- to 17-year-old online teen panel (n = 226). Results: Psychometric testing revealed a valid and reliable 21 item scale with a four-factor solution. The Cronbach's alpha for the total scale was .901. The four subscales and each subscale Cronbach's alpha were: (a) Active Participation In Healthcare with Psychosocial Support to Aid/Foster Good Healthcare Choices, (.826); (b) Transition Readiness to Self-Management with Family Support to Guide/Foster Health/Healthcare Decisions, (.825); (c) Proactivity and Empowerment to Have a Say in Health/Healthcare, (.747); and (d) Technology Use to Seek Health/Healthcare Information (.648). Conclusions: This study demonstrated the ACEI is a psychometrically sound instrument with good internal consistency for the overall scale and subscales. The ACEI can be implemented in clinical practice to measure adolescents' engagement capacity in their healthcare and identify appropriate interventions based on ACEI score. Further research to determine engagement capacity among teens of various populations is warranted.

Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers.

PURPOSE: The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. METHODS: Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. RESULTS: Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. CONCLUSION: Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.

Innovative Collaborative Partnerships to Conduct Multisite Research: Strategies for Success.

Multisite nursing research can be a challenging endeavor. A unique partnership between 5 clinical sites and a national research center of a healthcare technology organization led to the successful implementation of a multisite study. Strategies for success, obstacles encountered, benefits, implications for the Magnet journey, and leadership are discussed.

The Design and Testing of the Psychometric Properties of the Person Engagement Index Instrument to Measure a Person's Capacity to Engage in Health Care.

BACKGROUND AND PURPOSE: Patient engagement has been considered a powerful tool to improve health outcomes. A composite instrument to measure the factors that impact a person's capacity to engage in his or her health care was an identified gap in the literature. This study developed and tested the psychometric properties of the Person Engagement Index (PEI) instrument. METHODS: The instrument was tested among 338 medical-surgical inpatients at four health care systems (five facilities), with psychometric evaluation for validity, reliability, and exploratory factor analysis. RESULTS: Exploratory factor analysis revealed a four-factor solution that accounted for 63.9% of the total variance. Internal consistency results were Cronbach's α = .896 for the overall scale and each subscale: Engagement in Health Care = .885, Technology Use in Health Care = .854, Proactive Approach to Health Care = .728, and Psychosocial Support = .880. CONCLUSIONS: The results of the PEI study indicate that it is a valid and reliable instrument among the adult medical-surgical population. Further testing of the instrument is recommended among other populations and across the care continuum.

Effectiveness of technology use for engaging community dwelling adults with chronic disease in self-care behavior management in health care: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The quantitative objective is to identify the effectiveness of technology use for self-care behavior management and the patient engagement levels in health care.More specifically, the objectives are to identify: 1) the effectiveness of technology use (includes mobile health applications, text messages, telemedicine/video conferences between providers and people with chronic disease, remote monitoring and websites) in health care for engaging community-dwelling adults with chronic disease in self-care management, and 2) the patient engagement levels in health care.

Use of Gaming in Self-Management of Diabetes in Teens.

With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.

Patient and Family Engagement Summit: Needed Changes in Clinical Practice.

Patient and family engagement is a strategy to enhance healthcare outcomes through strong clinician-patient partnerships. A new care delivery process, in which the patient is the driver of the healthcare team, is required to achieve optimal health. A summit partially funded by a seed grant from the Robert Wood Johnson Executive Nurse Fellow Alumni Foundation was held with interprofessional colleagues and patient representatives to identify needed clinical competencies and future practice changes. Recommended shifts in the care delivery process included a focus on patient strengths, including the patient as a valued team member, doing care "with me" and not "to me," and considering all entities or providers including the patient, as equal partners.