Pathways for primary care practice adoption of patient engagement strategies

Objective To identify potential orderings of primary care practice adoption of patient engagement strategies overall and separately for interpersonally and technologically oriented strategies. Data Sources We analyzed physician practice survey data (n = 71) on the adoption of 12 patient engagement strategies. Study Design Mokken scale analysis was used to assess latent traits among the patient engagement strategies. Data Collection Three groupings of patient engagement strategies were analyzed: (1) all 12 patient engagement strategies, (2) six interpersonally oriented strategies, and (3) six technologically oriented strategies. Principal Findings We did not find scalability among all 12 patient engagement strategies, however, separately analyzing the subgroups of six interpersonally and six technologically oriented strategies demonstrated scalability (Loevinger's H coefficient of scalability [range]: interpersonal strategies, H = 0.54 [0.49-0.60], technological strategies, H = 0.42 [0.31, 0.54]). Ordered patterns emerged in the adoption of strategies for both interpersonal and technological types. Conclusions Common pathways of practice adoption of patient engagement strategies were identified. Implementing interpersonally intensive patient engagement strategies may require different physician practice capabilities than technological strategies. Rather than simultaneously adopting multiple patient engagement strategies, gradual and purposeful practice adoption may improve the impact of these strategies and support sustainability.