Patient commitment to health (PACT-health) in the heart failure population: A focus group study of an active communication framework for patient-centered health behavior change

Daniella Meeker, Jordan Goldberg, Katherine K Kim, Desi Peneva, Hugo De Oliveira Campos, Ross MacLean, Van Selby, Jason N. Doctor

Research output: Contribution to journalArticle

1 Scopus citations


Background: Over 6 million Americans have heart failure, and 1 in 8 deaths included heart failure as a contributing cause in 2016. Lifestyle changes and adherence to diet and exercise regimens are important in limiting disease progression. Health coaching and public commitment are 2 interactive communication strategies that may improve self-management of heart failure. Objective: This study aimed to conduct patient focus groups to gain insight into how best to implement health coaching and public commitment strategies within the heart failure population. Methods: Focus groups were conducted in 2 locations. We studied 2 patients in Oakland, California, and 5 patients in Los Angeles, California. Patients were referred by local cardiologists and had to have a diagnosis of chronic heart failure. We used a semistructured interview tool to explore several patient-centered themes including medication adherence, exercise habits, dietary habits, goals, accountability, and rewards. We coded focus group data using the a priori coding criteria for these domains. Results: Medication adherence barriers included regimen complexity, forgetfulness, and difficulty coping with side effects. Participants reported that they receive little instruction from care providers on appropriate exercise and dietary habits. They also reported personal and social obstacles to achieving these objectives. Participants were in favor of structured goal setting, use of online social networks, and financial rewards as a means of promoting health lifestyles. Peers were viewed as better motivating agents than family members. Conclusions: An active communication framework involving dissemination of diet- and exercise-related health information, structured goal setting, peer accountability, and financial rewards appears promising in the management of heart failure.

Original languageEnglish (US)
Article numbere12483
JournalJournal of Medical Internet Research
Issue number8
StatePublished - Jan 1 2019



  • behavioral economics
  • heart failure
  • motivational interviewing

ASJC Scopus subject areas

  • Health Informatics

Cite this