Abstract
The Health Care Empowerment Model offers direction for the investigation of patient-controlled engagement and involvement in health care. At the core of the model is the construct of Health Care Empowerment (HCE), for which there exist no validated measures. A set of 27 candidate self-report survey items was constructed to capture five hypothesized inter-related facets of HCE (informed, engaged, committed, collaborative, and tolerant of uncertainty). The full item set was administered to 644 HIV-infected persons enrolled in three ongoing research studies. Exploratory and confirmatory factor analyses resulted in a two factor solution comprising four items each on two subscales: (1) HCE: Informed, Committed, Collaborative, and Engaged HCE ICCE) and (2) HCE Tolerance of Uncertainty (HCE TU). Subscale scores were evaluated for relationships with relevant constructs measured in the three studies, including depression, provider relationships, medication adherence, and HIV-1 viral load. Findings suggest the utility of this 8-item Health Care Empowerment Inventory (HCEI) in efforts to measure, understand, and track changes in the ways in which individuals engage in health care.
Highlights
The construct of Health Care Empowerment (HCE) emerged out of a need for a broader conceptualization of engagement in medical treatment that encompasses multiple facets of participation in health care [1]
Because the HCE Model includes a range of hypothesized influences on engagement in medical care, there is potential for studies using an HCE framework to advance our understanding of the drivers of health disparities in such areas as cardiovascular disease, diabetes, and HIV
Sample 1 Validity and Reliability Analyses The scree plot suggested the presence of two common factors with eigenvalues of 14.12 and 2.46, respectively, in the exploratory factor analysis (EFA) analysis, which accounted for 61% of the shared variance among the 27 items
Summary
The construct of Health Care Empowerment (HCE) emerged out of a need for a broader conceptualization of engagement in medical treatment that encompasses multiple facets of participation in health care [1]. HCE is defined as the process and state of being 1) engaged, 2) informed, 3) collaborative, 4) committed to one’s health care and 5) tolerant or resilient to uncertainties in treatment outcomes. The HCE construct is housed within the larger HCE model, which is informed by multiple theoretical frameworks, including Social Action Theory, Stress and Coping Theory, Social Problem Solving Theory, and multiple derivations of the Health Belief Model [2,3,4]. Because the HCE Model includes a range of hypothesized influences on engagement in medical care, there is potential for studies using an HCE framework to advance our understanding of the drivers of health disparities in such areas as cardiovascular disease, diabetes, and HIV. Higher scores indicate a patient’s perception of greater opportunity for involvement as enabled by the provider
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