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This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional, Ministerio de Economia y Competitividad, Gobierno de Espana (PI15/00164, PI15/00586, PI15/00566). This is a public research funding source and played no role in study design, data collection, analysis or interpretation, or the manuscript's writing. The research retains complete independence in the conduct of the study. The Fondo de Investigacion Sanitaria evaluation committee will annually inspect study progress and adherence to the study protocol.

Analysis of institutional authors

Bermejo-Caja, CAuthor
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Article

A Virtual Community of Practice to Improve Primary Health Care Professionals' Attitudes Toward Patient Empowerment (e-MPODERA): A Cluster Randomized Trial

Publicated to:ANNALS OF FAMILY MEDICINE. 20 (3): 204-210 - 2022-05-01 20(3), DOI: 10.1370/afm.2799

Authors: Orrego, Carola; Perestelo-Perez, Lilisbeth; Isabel Gonzalez-Gonzalez, Ana; Ballester-Santiago, Marta; Koatz, Debora; Pacheco-Huergo, Valeria; Rivero-Santana, Amado; Ramos-Garcia, Vanesa; Mora Fernandez, Nuria; Torres-Castano, Alezandra; Bermejo-Caja, Carlos;

Affiliations

Avedis Donabedian Res Inst FAD, Barcelona, Spain - Author
Consejeria Sanidad, Direcc Gen Invest Docencia & Documentac, Subdirecc Gen Invest Sanitaria & Documentac, Madrid, Spain - Author
Fdn Canaria Inst Invest Sanitaria Canarias FISC, Tenerife, Spain - Author
Goethe Univ Frankfurt, Inst Gen Practice, Frankfurt, Germany - Author
Inst Catalan Salud, Ctr Atenc Primaria Turo, Barcelona, Spain - Author
Red Invest Serv Salud Enfermedades Cronicas REDIS, Bilbao, Spain - Author
Serv Evaluac & Planificac Serv Canario Salud SESC, Tenerife, Spain - Author
Serv Madrileno Salud, Gerencia Asistencial Atenc Primaria, Unidad Apoyo Tecn, Madrid, Spain - Author
Univ Autonoma Barcelona, Barcelona, Spain - Author
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Abstract

PURPOSE We aimed to evaluate the effectiveness of a virtual community of practice (vCoP) in improving primary health care professionals' (HCPs') attitudes toward empowering patients with chronic disease.METHODS We conducted a cluster randomized controlled trial. Practices were units of randomization, and primary HCPs and patients were units of analysis. Sixty-three practices in Madrid, Catalonia, and the Canary Islands were randomly allocated to the intervention or control groups. Randominzation of practices was performed after HCP and patient recruitment. The patients and statistician were anonymized to group allocation; it was not possible to anonymize HCPs. The intervention was a 12-month multicomponent tailored vCoP built on the Web 2.0 concept and focused on skills toward patient empowerment. The primary outcome was Patient-Provider Orientation Scale (PPOS) score at baseline and at 12 months. The secondary outcome was the Patient Activation Measure (PAM) score.RESULTS A total of 321 HCPs and 1,921 patients were assessed. The intervention had a positive effect on PPOS total score (0.14 points higher in the vCoP arm; 95% CI, 0.03-0.25; P =.011) and the PPOS Sharing subscale (0.3 points higher in the vCoP arm; 95% CI, 0.15-0.44; P <.001). No effect was found for the PPOS Caring subscale, and no significant differences were found for PAM scores.CONCLUSIONS A vCoP led to a minor increase in the PPOS Sharing component and the total score but not in the Caring component. However, considerable uncertainty remains, given the observed attrition and other limitations of the study. Further research is needed on the effectiveness of the vCoP model and on how to improve HCP engagement.

Keywords
chronic diseasespatient empowermentpatient-centered careChronic diseasesExplanationPatient empowermentPatient-centered careSelf-managementValidationVirtual community of practice

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal ANNALS OF FAMILY MEDICINE due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 2/18, thus managing to position itself as a Q1 (Primer Cuartil), in the category Primary Health Care. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 5, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 6.32 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-02, the following number of citations:

  • WoS: 2
  • Scopus: 8
  • Europe PMC: 2
  • OpenCitations: 7
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 55.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 52 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 16.8.
  • The number of mentions on the social network X (formerly Twitter): 11 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Germany.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (BERMEJO CAJA, CARLOS JESUS).