TY - JOUR
T1 - Understanding the context of health for persons with multiple chronic conditions
T2 - Moving from what is the matter to what matters
AU - Bayliss, Elizabeth A.
AU - Bonds, Denise E.
AU - Boyd, Cynthia M.
AU - Davis, Melinda M.
AU - Finke, Bruce
AU - Fox, Michael H.
AU - Glasgow, Russell E.
AU - Goodman, Richard A.
AU - Heurtin-Roberts, Suzanne
AU - Lachenmayr, Sue
AU - Lind, Cristin
AU - Madigan, Elizabeth A.
AU - Meyers, David S.
AU - Mintz, Suzanne
AU - Nilsen, Wendy J.
AU - Okun, Sally
AU - Ruiz, Sarah
AU - Salive, Marcel E.
AU - Stange, Kurt C.
N1 - Funding Information:
Funding support: Dr Stange's time is supported in part by a Clinical Research Professorship from the American Cancer Society and by the National Cancer Society through the Intergovernmental Personnel Act.
PY - 2014
Y1 - 2014
N2 - Purpose: An isolated focus on 1 disease at a time is insufficient to generate the scientific evidence needed to improve the health of persons living with more than 1 chronic condition. This article explores how to bring context into research efforts to improve the health of persons living with multiple chronic conditions (MCC). Methods: Forty-five experts, including persons with MCC, family and friend caregivers, researchers, policy makers, funders, and clinicians met to critically consider 4 aspects of incorporating context into research on MCC: key contextual factors, needed research, essential research methods for understanding important contextual factors, and necessary partnerships for catalyzing collaborative action in conducting and applying research. Results: Key contextual factors involve complementary perspectives across multiple levels: public policy, community, health care systems, family, and person, as well as the cellular and molecular levels where most research currently is focused. Needed research involves moving from a disease focus toward a person-driven, goal-directed research agenda. Relevant research methods are participatory, flexible, multilevel, quantitative and qualitative, conducive to longitudinal dynamic measurement from diverse data sources, sufficiently detailed to consider what works for whom in which situation, and generative of ongoing communities of learning, living and practice. Important partnerships for collaborative action include cooperation among members of the research enterprise, health care providers, community-based support, persons with MCC and their family and friend caregivers, policy makers, and payers, including government, public health, philanthropic organizations, and the business community. Conclusion: Consistent attention to contextual factors is needed to enhance health research for persons with MCC. Rigorous, integrated, participatory, multimethod approaches to generate new knowledge and diverse partnerships can be used to increase the relevance of research to make health care more sustainable, safe, equitable and effective, to reduce suffering, and to improve quality of life.
AB - Purpose: An isolated focus on 1 disease at a time is insufficient to generate the scientific evidence needed to improve the health of persons living with more than 1 chronic condition. This article explores how to bring context into research efforts to improve the health of persons living with multiple chronic conditions (MCC). Methods: Forty-five experts, including persons with MCC, family and friend caregivers, researchers, policy makers, funders, and clinicians met to critically consider 4 aspects of incorporating context into research on MCC: key contextual factors, needed research, essential research methods for understanding important contextual factors, and necessary partnerships for catalyzing collaborative action in conducting and applying research. Results: Key contextual factors involve complementary perspectives across multiple levels: public policy, community, health care systems, family, and person, as well as the cellular and molecular levels where most research currently is focused. Needed research involves moving from a disease focus toward a person-driven, goal-directed research agenda. Relevant research methods are participatory, flexible, multilevel, quantitative and qualitative, conducive to longitudinal dynamic measurement from diverse data sources, sufficiently detailed to consider what works for whom in which situation, and generative of ongoing communities of learning, living and practice. Important partnerships for collaborative action include cooperation among members of the research enterprise, health care providers, community-based support, persons with MCC and their family and friend caregivers, policy makers, and payers, including government, public health, philanthropic organizations, and the business community. Conclusion: Consistent attention to contextual factors is needed to enhance health research for persons with MCC. Rigorous, integrated, participatory, multimethod approaches to generate new knowledge and diverse partnerships can be used to increase the relevance of research to make health care more sustainable, safe, equitable and effective, to reduce suffering, and to improve quality of life.
KW - Chronic illness
KW - Health services research
KW - Multiple chronic conditions
UR - http://www.scopus.com/inward/record.url?scp=84900428210&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84900428210&partnerID=8YFLogxK
U2 - 10.1370/afm.1643
DO - 10.1370/afm.1643
M3 - Article
C2 - 24821898
AN - SCOPUS:84900428210
SN - 1544-1709
VL - 12
SP - 260
EP - 269
JO - Annals of family medicine
JF - Annals of family medicine
IS - 3
ER -