Purpose: To examine why high-risk individuals targeted for a telephone care management program participated at low rates.
Design: Study design consisted of qualitative, semistructured interviews.
Setting: The setting was a large national insurer's telephone-based care management program. The program employed registered nurses to provide individually tailored education and counseling about health and health care.
Subjects: Study subjects comprised members of a national insurer who were recruited to participate in a care management program but had either dropped out of the program after a short period of initial engagement or had never participated despite recruitment efforts.
Measures: Interview content was divided into four categories: knowledge of the case management program, barriers to program participation, perceptions of benefits of the program, and suggestions for program improvement.
Analysis: Investigators conducted a directed content analysis.
Results: The most commonly cited barriers to participation were a lack of perceived need and a sense of distrust toward the program and its staff. The most commonly cited benefits were psychosocial support and goal setting.
Conclusion: Care management programs may benefit from changes to how insurance plan members are selected for the program and from adjusting program content to address perceived needs among members.
Keywords: Care Coordination; Chronic Disease; Disease Management; Health Behavior; Patient Care Management; Patient-Centered Care; Prevention Research. Manuscript format: research; Research purpose: descriptive; Study design: qualitative; Outcome measure: patient-reported themes; Setting: national; Health focus: chronic disease management; and weight control; Strategy: education and skill building/behavior change; Target population age: adults; including fitness/physical activity; stress management.