Understanding Behavior to Boost Patient Engagement and Adherence

November 12, 2020 | Stericycle Communication Solutions

Daily routines. Mental health stigmas. Socioeconomic constraints. Family support. These are just some of the underlying considerations on the minds of patients when dealing with new treatments or diagnoses. And whether it’s learning about a chronic condition that can be managed through ongoing lifestyle changes or receiving an acute diagnosis that requires immediate care, actually “hearing” all the information and taking appropriate actions can be challenging for patients and their caregivers.

Learn six practical tips for improving patient adherence during COVID-19

Having a deeper understanding of patient behavior can improve the success of your patient outreach and adherence programs. Specifically, patient behavior models explore the physical and psychological constraints of a patient’s illness and behavioral response, taking a wide range of attributes or factors into consideration. These models highlight patient motivators and allow healthcare professionals to empathize and better communicate with patients.

One of the primary models used by healthcare systems to understand patient behaviors is the biopsychosocial (BPS) model. The BPS model views health and illness behaviors and patient willingness to engage in care as the product of biological characteristics (such as genes and disease constraints), behavioral factors (such as lifestyle, stress, and health literacy), and social conditions (such as socioeconomic status, family relationships, and social support).

Learning about each segment of the BPS model and how it impacts patient behavior can help providers improve patient engagement and adherence.

Biological Segment

The model’s biological component examines genetics and the progression of the disease on the body and takes into consideration the effect of symptoms on daily life and the fluctuation of the symptoms plus resulting feelings of uncertainty. In this segment, providers should realize that patients could have physical or health barriers that prevent them from taking the typical steps to engage in their care. For example, a patient with low mobility could potentially benefit from telehealth visits and remote patient monitoring when they can’t connect in person for care. Additionally, virtual education programs aimed at managing their condition can also be of great benefit to biological adherence barriers.

Psychological Segment

The psychological segment addresses the emotions and perceptions triggered by the presence and symptoms of the disease. Patients often experience increased anxiety and depression. In some situations, there may also be a perception that the patient’s lack of self-management caused the disease, which can lead to feelings of guilt or anger. This segment is one of the largest barriers to patient adherence as patient perception interferes with care protocols. For example, a patient may have a fear of needles or pain being caused during a physical appointment and put off preventative care to avoid potential stressors. Tailored patient communications aimed at easing patient anxiety can help when doctors have full visibility into the reasons why patients avoid care or fall off treatment plans and intervene with reassurance.

Socioeconomic Segment

The socioeconomic component assesses how the disease affects the patient’s relationships with friends and family and the perceived stigma of the condition. Financial and living situations can also impact adherence to treatment in cases of homelessness, and lack of technology or privacy for virtual visits. Within this segment, encouraging family support and education is of high importance. It’s also imperative to understand socioeconomic barriers to adherence such as access to transportation, access to telehealth, and language barriers that may be overcome by offering hospital programs to alleviate these challenges.

How does this impact patient adherence?

Behavioral models like BPS help healthcare professionals gather information and develop a more complete understanding of the patient. This holistic approach to patient support allows improvement in the overall treatment experience. Through patient behavior models and frameworks, health systems can modify communications to increase patient action and encourage better adherence. Here at Stericycle, we looked at patient preferences for video visits versus phone visits in a patient population as shown in the below infographic.


As you can see, patient preferences were impacted by something as simple as how late in the evening the visit was conducted. While video visits have grown during the pandemic, they were least desired late at night. One could imagine that patients didn’t want to be on camera due to privacy concerns or embarrassment over being dressed for bed during the night time hours. While visits were successfully achieved regardless of mechanism, it shows how the psychological components of patient behavior can easily impact treatment. Conducting data samples across patient populations like this can give care teams a better understanding of what might work to engage patients.

Here are other ways you can use behavior change models to improve patient action and adherence:

  • Engage throughout the journey —Examine and address multiple stages in the journey from engagement to ongoing treatment and find the areas where patients are most likely to disengage.
  • Boost health literacy —Provide information about treatment efficacy and safety along with access to well-rounded educational programs and support groups. Additionally, offer easy appointment and class and event scheduling through multiple channels, including online and by phone, to meet diverse patient needs.
  • Improve outcomes through better nutrition —Offer nutrition education and cooking programs, provider advice, and dietary self-management protocols to help patients whose conditions can be improved through better nutrition. Encourage partnerships with local food pantries and co-ops to help patients get access to the nutritious foods they need.
  • Build support groups —Facilitate peer-to-peer education and support both in-person (where appropriate) and virtually. Ensure these programs are well advertised to patients and allow for easy online booking.

Effective patient support goes beyond providing patients with treatment information. It begins with a greater understanding of patient behavior and catering to patients’ biological, psychological, and socioeconomic needs. With a greater understanding of patient behavior, health and wellness programs can be designed to better engage patients to take action and ultimately improve their health outcomes.

If your health system is looking to design and structure patient engagement strategies that improve patient access, action, and adherence, we can help. To learn more about additional ways to boost patient adherence, download our eBook.

Patient Adherence During A Pandemic. 6 practical tips to engage patients in their care now.  Download the Ebook

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