Date of Conferral

9-5-2025

Degree

Doctor of Public Administration (D.P.A)

School

Public Policy and Administration

Advisor

Richard Worch

Abstract

This study was developed to address the partner site's need for an evidence-based approach to improving patient engagement among elderly individuals managing chronic diseases. Low engagement, often driven by poor provider–patient communication, non-compliance, and limited use of healthcare technology, was identified as a barrier to effective self-management and optimal health outcomes. Guided by the social cognitive theory, behavioral, cognitive, and environmental factors influencing engagement and self-efficacy were examined. Two practice-focused questions examined: identifying barriers to engagement and the impact of the provider–patient relationship on outcomes. The purpose of the project was to develop an evidence-based approach to enhance patient engagement. A quantitative, cross-sectional survey of 20 participants aged 50 and older was conducted to measure engagement, communication, and technology use. Analysis using multivariate logistic regression revealed a positive relationship between patient engagement and health outcomes, while highlighting gaps in disease knowledge and medication adherence. The provider–patient relationship emerged as a significant factor in influencing engagement. The study found that patient engagement improves health outcomes, with few manageable barriers. Surveys effectively assessed engagement. Applying the social cognitive theory in public administration supported behavior-based strategies that enhanced self-efficacy. Recommendations included health literacy, chronic disease, and nutrition education to support older adults managing chronic conditions. The study has implications for public administrative practice and positive change through improved health literacy and engagement in older adults.

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