Christos Lionis
Sophia Papadakis
Marilena Anastasaki
Ana M. Carriazo- 1Laboratory of Health and Society, School of Medicine, University of Crete, Crete, Greece
- 2Junta de Andalucia, Sevilla, Spain
Editorial on the Research Topic
Empowering patients and supporting patient-centered care: a spotlight on health behavior change
The COVID-19 pandemic has had a major impact on both mental and physical health, with documented and ongoing effects on the health status of populations globally (1–6). Some of the drivers of these trends include the rise in risk factors and unhealthy behaviors in the population (e.g., obesity, smoking, and alcohol consumption); poor adherence to health screening, vaccination, or other preventative interventions; and increased rates of mental illness (4–13). Importantly, the greatest effects have been documented in the most vulnerable populations (3, 6, 14).
The pandemic's effects highlight the need for actions targeted toward disease prevention, with a focus on health behavior change. It is recognized that such interventions should be grounded in the principles of person-centered approaches, including patient empowerment and compassionated care provision, in order to address the complex interactions between mental and physical health and promote effective communication between healthcare professionals and patients (15–17). Sharing international learning and best practice for promoting health behavior change is key to supporting the rapid scale-up of effective intervention strategies.
This Frontiers in Medicine Research Topic “Empowering Patients and Supporting Patient-Centered Care: A Spotlight on Health Behavior Change” sought to collect the best and most promising empowerment-oriented strategies for supporting health behavior change. One of our key ambitions for this Research Topic was the examination of methods that address individuals, populations, and healthcare professionals and aim to reduce the risk of disease, promote healthy behaviors, or enhance adherence to healthcare interventions. The four themes that this topic aimed to include were
1. interventions and initiatives to address chronic disease risk factors including smoking cessation, alcohol use reduction, and physical exercise improvement,
2. interventions and initiatives to improve self-management and care of chronic diseases, including adherence to medicine and other therapies,
3. interventions and initiatives to prevent communicable/infectious diseases and associated behaviors, such as vaccination and other preventative interventions and policies,
4. experience and interventions focused on transferring effective interventions into complex settings and contexts focusing on multimorbidity and frailty.
We had the pleasure of communicating with many research teams and, ultimately, a collection of nine manuscripts has been published as part of this Research Topic.
Improving patient-centered mental health promotion in primary health care (PHC) to support vulnerable communities through mindfulness training was the focus of a Brazilian intervention by Teixeira et al.. Their intervention was based on the Mindfulness-Based Health Promotion Model, which promotes self-care and psychological support in PHC. PHC and self-care were also the focus of a systematic review by Rakers et al., which demonstrated that population health management (PHM)-related interventions can reach many participants and are effective in reducing cardiometabolic risk factors. Self-management and self-care are among the most challenging issues that PHC and public health practitioners have to address to achieve the United Nations Sustainable Development Goal #3 “Ensuring a healthy life and promoting wellbeing for all ages” (18). The role of caregivers in achieving this target is also vital and the WHO Astana Declaration (2018) emphasizes the need to turn our attention to this group of care providers (19). Mas-Casadesus et al., in their original article, underline the need for policymakers to introduce community-based and planned interventions aimed at caregivers to improve the management of vulnerable people during periods of isolation. The findings are particularly relevant given the isolation that was experienced by a large number of people and caregivers during and after the pandemic. A perspective article by Cipta et al. reported on the impact of integrating culture-specific patient empowerment practices into healthcare settings in Indonesia. This article underscores the potential for improved health outcomes, heightened patient engagement, and the delivery of cultural services within low and middle-income countries.
This Research Topic includes two articles that address COVID-19 vaccine hesitancy, a subject that is particularly relevant given the challenges reported worldwide in achieving national vaccination program targets (3, 20, 21). Papadakis et al., reported on the development and pilot testing of an eLearning intervention for PHC practitioners and social care providers to reduce vaccination hesitancy among patients in Greece. The intervention sought to develop training on how Very Brief Advice (VBA) and motivational interviewing (MI) can be adapted to promote COVID-19 vaccine uptake and address ambivalence and resistance among patients. In a similar direction, Lorenzo et al., in their policy report, stressed the need for effective communication strategies to tackle vaccination hesitancy. They clearly underlined that trained professionals should curate communication with the public.
Saeed et al., in their original research, reported the level of satisfaction among COVID-19 survivors and discussed the challenges of healthcare affordability and the role of healthcare practitioners in Northeast India. They consider the challenges in healthcare affordability and timeliness as important. The challenge of value-based primary care, which measures improvement in patient health outcomes relative to the cost of achieving that improvement, was the focus of a article by Rangachari. This article examines how healthcare consumerism can act as a barrier or facilitate the implementation of value-based primary care.
Fernandes et al., in their study protocol, presented the key elements of a feasibility study for Parkinson's disease. Apart from its focus on Parkinson's as a growing health concern, this small study provided insights into the design of a community-based intervention that encompasses elements of group cognitive behavioral therapy in addition to disease management and training techniques. Such interventions in the community addressing chronic illness and disability with a focus on behavior and mental health may offer important lessons for enabling and empowering patients through health behavior support.
We hope the collection of articles featured in this Research Topic will give prominence to the importance of patient-centered approaches in improving self-care and facilitating behavior change. We are pleased to be able to share this collection of articles with the field and hope it serves to inform and inspire practitioners, policymakers, and researchers on the importance of patient-centered models to health behavior change as we continue to address the health of populations with a new perspective and insight in the post-pandemic period, with an eye to future potential health crises.
Author contributions
CL: Writing – review & editing, Writing – original draft, Validation, Supervision, Project administration, Methodology, Investigation, Data curation, Conceptualization. SP: Writing – review & editing, Writing – original draft, Validation, Supervision, Project administration, Methodology, Investigation, Data curation, Conceptualization. MA: Writing – review & editing, Writing – original draft, Validation, Supervision, Project administration, Methodology, Investigation, Data curation, Conceptualization. AC: Writing – review & editing, Project administration, Investigation, Conceptualization.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
Publisher's note
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References
1. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. (2022) 28:583–90. doi: 10.1038/s41591-022-01689-3
2. Sun Y, Wu Y, Fan S, Dal Santo T, Li L, Jiang X et al. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ. (2023) 380:e074224. doi: 10.1136/bmj-2022-074224
3. World Health Organization. Global COVID-19 Vaccination. Geneva: World Health Organization. (2021). Available at: https://cdn.who.int/media/docs/default-source/immunization/sage/covid/global-covid-19-vaccination-strategic-vision-for-2022_sage-yellow-book.pdf (accessed August 10, 2024).
4. World Health Organization (WHO). Mental Health and COVID-19: Early Evidence of the Pandemic's Impact: Scientific Brief . Geneva: WHO (2022). Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022 (accessed August 10, 2024).
5. World Health Organization (WHO). A Healthy Return: Investment Case for a Sustainability Financed WHO. Chapter 2: Current Context: the COVID-19 Pandemic and Continuing Challenges to Global Health. Geneva: WHO. (2022) Available at: https://www.who.int/about/funding/invest-in-who/investment-case-2.0/challenges (accessed August 10, 2024).
6. World Health Organization (WHO). World Health Statistics 2024: Monitoring Health for the SDGs, Sustainable Development Goals. Geneva: WHO. (2024). Available at: https://www.who.int/publications/i/item/9789240094703 (accessed August 10, 2024).
7. Bouza E, Arango C, Moreno C, Gracia D, Martín M, Pérez V, et al. Impact of the COVID-19 pandemic on the mental health of the general population and health care workers. Rev Esp Quimioter. (2023) 36:125–43. doi: 10.37201/req/018.2023
8. Moynihan R, Sanders S. Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. (2021) 11:e045343. doi: 10.1136/bmjopen-2020-045343
9. Carreras G, Lugo A, Stival C, Amerio A, Odone A, Pacifici R, et al. Impact of COVID-19 lockdown on smoking consumption in a large representative sample of Italian adults. Tobacco Control. (2022) 31:615–22. doi: 10.1136/tobaccocontrol-2020-056440
10. Chen DT. The psychosocial impact of the COVID-19 pandemic on changes in smoking behavior: evidence from a nationwide survey in the UK. Tob Prev Cessation. (2020) 6:59. doi: 10.18332/tpc/126976
11. Niedzwiedz CL, Green MJ, Benzeval M, Campbell D, Craig P, Demou E, et al. Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study. J Epidemiol Community Health. (2021) 75:224–31. doi: 10.1136/jech-2020-215060
12. Thai PK, Tscharke BJ, O'Brien J, Gartner C, Bade R, Gerber C, et al. Increased nicotine consumption in australia during the first months of the COVID-19 pandemic. Nicot Tob Res. (2023) 23:1194–7. doi: 10.1093/ntr/ntac275
13. Saxena S, Skirrow H, Bedford H. Routine vaccination during covid-19 pandemic response. BMJ. (2020) 369:m2392. doi: 10.1136/bmj.m2392
14. British Medical Association (BMA). The Impact of the Pandemic on Population Health and Health Inequalities. London: BMA. (2024). Available at: https://www.bma.org.uk/advice-and-support/covid-19/what-the-bma-is-doing/the-impact-of-the-pandemic-on-population-health-and-health-inequalities (accessed August 10, 2024).
15. Völkel G, Fürstberger A, Schwab JD, Werle SD, Ikonomi N, Gscheidmeier T, et al. Patient empowerment during the COVID-19 pandemic by ensuring safe and fast communication of test results: implementation and performance of a tracking system. J Med Internet Res. (2021) 23:e27348. doi: 10.2196/27348
16. Su JJ, Bayuo J, Lin RSY, Wong AKC, Abu-Odah H, He Q, et al. Compassionate care during the COVID-19 pandemic. BMC Nurs. (2024) 23:173. doi: 10.1186/s12912-024-01827-x
17. Ohta R, Ikeda H, Sawa J. The importance of patient-centered care during the COVID-19 pandemic: lessons from a rural ward in Japan. J Rural Med. (2021) 16:128–9. doi: 10.2185/jrm.2020-045
18. United Nations. Sustainable Health Goals 3: ensure healthy lives and promote wellbeing for all at all ages. In: United Nations, Department of Economic and Social Affairs. Available at: https://sdgs.un.org/goals/goal3 (accessed August 10, 2024).
19. World Health Organization. Declaration of Alma Ata. Geneva: World Health Organization. (2018). Available at: https://www.who.int/publications/i/item/WHO-HIS-SDS-2018.61 (accessed August 10, 2024).
20. Fajar JK, Sallam M, Soegiarto G, Sugiri YJ, Anshory M, Wulandari L, et al. Global prevalence and potential influencing factors of COVID-19 vaccination hesitancy: a meta-analysis. Vaccines. (2022) 10:1356. doi: 10.3390/vaccines10081356
Keywords: empower, support, patient-centered care, health behavior (MeSH), change
Citation: Lionis C, Papadakis S, Anastasaki M and Carriazo AM (2024) Editorial: Empowering patients and supporting patient-centered care: a spotlight on health behavior change. Front. Med. 11:1474005. doi: 10.3389/fmed.2024.1474005
Received: 31 July 2024; Accepted: 09 August 2024;
Published: 30 August 2024.
Edited and reviewed by: Arch Mainous, University of Florida, United States
Copyright © 2024 Lionis, Papadakis, Anastasaki and Carriazo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Christos Lionis, bGlvbmlzJiN4MDAwNDA7dW9jLmdy