Take an Active Role in Your Health

Being proactive can help you bounce back more quickly when your health takes a turn for the worse. Here's how to take an active role in your health.

To optimize living your healthiest life, you should take an active role in your health.

One important factor is what Judith Hibbard, PhD, a faculty fellow at the University of Oregon Institute for Policy Research and Innovation, calls “patient activation” — how much care a person puts into their health.

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Through research, Hibbard and colleagues identified four levels of patient activation, which they used to develop the patient activation measure, or PAM:

1. Believing in the importance of taking an active role in your health is the first step.
2. Having the confidence and knowledge to take action to protect and improve your health comes next.
3. Taking even more positive health actions results as confidence, and knowledge increases.
4. Staying the course under stress is crucial when health challenges arise and require increased patient action.

To measure PAM, the researchers developed a 13-item questionnaire to address knowledge, confidence, and the ability to act on health issues, such as when to take medications or get medical care.

The results of PAM scores, studied in several environments, have shown improved health in people with the most “activated” scores. Where are you on the health activation scale? And what can you do to raise your numbers?

If the amount of information you receive from your doctors is confusing, you may be a level 1 or 2 on the scale.

“I think too often we give people a list of things to change about their life, and it's overwhelming,” Hibbard says. “And the upshot of that is that they usually don't do any of it.”

If that’s you, simply paying attention to your habits is a good way to start. Hibbard suggests asking yourself: “How much am I actually moving around? How much am I actually eating in a week?” That type of attention — often called mindfulness — is a helpful first step.

Next, ask your doctor to help you prioritize complex health information. “For any given situation, you really can become overwhelmed with the amount of information and instructions and things that need to be done,” Hibbard says. “Your doctor can help you by saying, ‘If you only do two things, do these two things.’”

Starting with small steps and experiencing success have both been shown to help people move to the next level of activation, which involves making behavior changes. Breaking things down into smaller steps, building up a foundation of skills like self-awareness, and developing small habits that add up over time to be good health behaviors are all important, according to Hibbard.

Finally, anticipate challenges. What if your work schedule doesn’t allow for a complex medication or dietary regimen, or you’re not sure how to get in enough physical activity each day? Your doctors can help you think through problems like these.

If you’re higher on the activation scale — levels 3 and 4 — you’re ready to make specific changes, such as exercising three times a week or ensuring you get three to five servings of fruits and vegetables every day.

At this level, the health benefits become apparent, according to Hibbard’s research. Not only that, people who are more activated are more satisfied with their healthcare.

“I think that's because they have more realistic expectations,” she says. “They know what they want, so they're more satisfied, they have better communication with their doctors, and they have better medical outcomes and lower costs.”

What’s more, doctors themselves can help raise activation levels.

“Clinicians need to understand where their patients are coming from and respond appropriately,” she says. “So, if they're less activated, they need to not pile on the changes or the information and break things down into smaller steps. For more activated patients, doctors need to work with patients to meet them where they are by being more inclusive in how they communicate and work with those patients.”

Many hospitals across the U.S. use PAM to identify patients who need additional support. Patients with lower activation — who are about twice as likely to be readmitted after a discharge — may receive phone calls or even home visits to help them continue with optimal care at home.

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