All ETDs from UAB

Advisory Committee Chair

Robert Hernandez

Advisory Committee Members

Nancy Borkowski

Bisakha Sen

Myles Spar

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


Activated patients believe they have essential roles in achieving and maintaining their health. Patient activation is strongly related to improved clinical outcomes (Hibbard, 2017; Greene, 2013). The study’s primary purpose is to evaluate the use of Integrative Medicine Interventions (IMIs) and their relationship to patient activation levels; and to investigate the association between IMI protocols and patient activation levels on patient reported outcomes (PROs) for those with chronic diseases, specifically chronic fatigue and mental health-related conditions of anxiety and depression, using the principles of Integrative Medicine’s (IM) whole-person approach as the model of care in independent IM practices across the United States. Three frameworks guided this study. First, Self Determination Theory (SDT) is the framework that builds an understanding of human motivation and personality in social contexts. The second is Patient Activation Measure (PAM), the framework that quantifies patients’ levels of engagement. Lastly, PROMIS is a highly reliable, precise measure of patient reported health status for physical, mental, and social well-being. A quantitative, non-experimental research design was used in the study featuring retrospective data ascertained through a research survey approach. The study’s two research questions were addressed using predictive modeling techniques. IMI protocols exerted a statistically significant predictive effect upon Patient Activation Level for the health condition of chronic fatigue and the mental health conditions of anxiety and iv depression. Exercise protocols, both aerobic and strength building, were most consistent in exerting statistically significant predictive effects for the health issues of chronic fatigue and the mental health issues of anxiety and depression. Patient Activation Level, in turn, represented a robust, statistically significant predictor of improved outcomes for the health condition of chronic fatigue and mental health condition of anxiety and depression. Patient Activation Level exerted the greatest degree of predictive effect on the mental health issue of depression.



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