Using the PH42 and I.ROC12 as Measurement Tools to evaluate a person-centred and holistic approach in Integrated Care Settings

Background: Integrated care programmes engage people as active partners in their health by coordinating services around individual strengths and community connections to enhance health and wellbeing for diverse healthcare users. The Positive Health philosophy can guide integrated care practices by providing strength-oriented dialogue tools and evaluation methods that enable practitioners and healthcare users to discuss health holistically and measure this person-centred approach beyond traditional disease indicators.

 

Approach: Our research assessed two tools, originally developed to guide person-centred dialogue in health practices, for their suitability to measure individuals' self-management, resilience, adapting to life challenges, and meaningful connections. In two studies, involving 2,457 Dutch adults randomly included from the general population, these two tools were tested as tools for measuring (Positive) Health from a holistic perspective: the comprehensive 42-item Positive Health tool (PH42) and the shorter 12-item recovery tool (I.ROC12).

 

We tested the questionnaires’ psychometric properties following the COSMIN guideline to assess their dimensionality, construct validity, and ability to assess differences between subgroups in a general population.

 

Results: It was found that the PH42 consists of six measurement dimensions: Acceptance, meaningfulness and satisfaction with life, Physical health and functioning, Self-management, Social network and societal roles, Personal development, and Cognition. The I.ROC12 consisted of two measurement dimensions: Wellbeing, control, network and meaningfulness, and Health, safety and abilities. Both tools are distinctive for measuring health among subgroups of educational levels and degree of healthcare use. Overall, psychometric properties of both tools were good, supporting their validity.

 

Implications: for integrated care: To evaluate Positive Health aspects and diversities for integrated care programmes these measurement tools provide practical instruments for dialogue and measurement. Key learning points include: (1) knowledge about the feasibility of broad health measurement tools for integrated care teams to (2) identify where holistic and person centred services are needed, (3) monitor the progress towards the implementation of working with broad strength oriented and person centred health goals, (4) evaluate whether integrated care practices effectively support multidimensional (Positive) Health aspects, and (5) evaluate whether coordinated interventions increase resilience, self-management and meaningful connections for diverse health users.

 

Keywords: positive health measurement, integrated care, diversity, person-centred outcomes, health diversity