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Patient—Provider Communication

Understanding the Role of Patient Activation for Latinos in Mental Health Treatment

Cambridge Health Alliance, Harvard Medical School, Boston, Massachusetts

Norah Mulvaney-Day, PhD

Center for Multicultural Mental Health Research, Somerville, Massachusetts, and Harvard Medical School, Boston, Massachusetts, nmulvaney-day{at}charesearch.org

Lisa Fortuna, MD, MPH

University of Massachusetts Medical School, Worcester

Sarah Reinfeld, BA

Center for Multicultural Mental Health Research, Somerville, Massachusetts

Margarita Alegría, PhD

Center for Multicultural Mental Health Research, Somerville, Massachusetts, and Harvard Medical School, Boston, Massachusetts

This article highlights results from the Right Question Project—Mental Health (RQP-MH), an intervention designed to teach skills in question formulation and to increase patients' participation in decisions about mental health treatment. Of participants in the RQP-MH intervention, 83% were from a Latino background, and 75% of the interviews were conducted in Spanish. The authors present the steps participants undertook in the process of becoming "activated" to formulate effective questions and develop decision-making skills in relation to their care. Findings suggest that patient activation and empowerment are interdependent because many of the skills (i.e., question formulation, direct patient—provider communication) required to become an "activated patient" are essential to achieve empowerment. Also, findings suggest that cultural and contextual factors can influence the experience of Latinos regarding participation in health care interactions. The authors provide recommendations for continued research on the patient activation process and further application of this strategy in the mental health field, especially with Latinos.

Key Words: Latino • mental health • patient activation • patient communication • patient—provider communication

This version was published on February 1, 2009

Health Education & Behavior, Vol. 36, No. 1, 138-154 (2009)
DOI: 10.1177/1090198108314618


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