The Relationship Between Race, Patient Activation, and Working Alliance: Implications for Patient Engagement in Mental Health Care

  • Johanne Eliacin
  • Jessica M. Coffing
  • Marianne S. Matthias
  • Diana J. Burgess
  • Matthew J. Bair
  • Angela L. Rollins
Original Report


This study explored the relationship between race and two key aspects of patient engagement—patient activation and working alliance—among a sample of African-American and White veterans (N = 152) seeking medication management for mental health conditions. After adjusting for demographics, race was significantly associated with patient activation, working alliance, and medication adherence scores. Patient activation was also associated with working alliance. These results provide support for the consideration of race and ethnicity in facilitating patient engagement and patient activation in mental healthcare. Minority patients may benefit from targeted efforts to improve their active engagement in mental healthcare.


Patient activation Patient engagement Mental health African-Americans 



The authors thank Linda Collins, Erica Evans, Jessica McGlynn, and Zamal Frank for their assistance with data collection.


The projects reported here were supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Pilot Grant (PPO 13-395), VA Health Services Research and Development (HSR&D) Center for Innovation (CIN 13-416), and Center for Health Information and Communication Locally Initiated Project fund.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • Johanne Eliacin
    • 1
    • 2
    • 3
    • 4
  • Jessica M. Coffing
    • 1
  • Marianne S. Matthias
    • 1
    • 3
    • 5
    • 8
  • Diana J. Burgess
    • 6
    • 7
  • Matthew J. Bair
    • 1
    • 3
    • 8
    • 9
  • Angela L. Rollins
    • 1
    • 2
    • 3
    • 4
  1. 1.Center for Health Information and Communication, CHIC, Health Services Research & DevelopmentRichard L. Roudebush VA Medical CenterIndianapolisUSA
  2. 2.Department of PsychologyIndiana University Purdue University at IndianapolisIndianapolisUSA
  3. 3.Center for Health Services ResearchRegenstrief Institute, Inc.IndianapolisUSA
  4. 4.ACT Center of IndianaIndianapolisUSA
  5. 5.Communication StudiesIndiana University Purdue University at IndianapolisIndianapolisUSA
  6. 6.Center for Chronic Disease Outcomes Research (CCDOR)Minneapolis VA Health Care SystemMinnesotaUSA
  7. 7.Department of MedicineUniversity of MinnesotaMinnesotaUSA
  8. 8.Indiana University School of MedicineIndianapolisUSA
  9. 9.Indiana University Center for Health Services and Outcomes ResearchIndianapolisUSA

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