What Is Health Engagement and How Do You Apply It?

health engagementAn apple a day keeps the doctor away” used to be the epitome of a healthy diet in bygone eras.

Fortunately, in recent years, a global movement towards healthy living has taken hold. No longer prodded to ‘eat more greens’ by a white-coated individual sporting glasses, humans are now much more active participants in pursuing healthy habits.

With health care costs and mortality rates from chronic illnesses soaring, we are fully aware of how our daily habits manifest themselves in our minds and bodies. Still, with a smorgasbord of information on health and wellness, too few take advantage of actively engaging in their own health.

What would it take to motivate an individual to embrace personal responsibility and self-care? How does one move the conversation to integrate health engagement and positive mental health and thereby improve vitality and wellness?

Let’s explore health engagement and see what it means for illness, and that ultimate attainment of optimal health.

Patient Health Engagement

An individual’s involvement in the process of improving wellness is vital. Empowering individuals to fully understand and pursue positive habit change, is never a “one size fits all” approach. There is resistance to change for most people.

Health care providers of all types have made shifts toward a patient-centered plan for achieving improvement in wellness. Patients feeling a sense of ownership over their health allows for intrinsic motivation in decision making around behavior and personal responsibility for one’s wellness.

Creating plans with a patient need to recognize the movement in the following areas:

  • Behavior change motivation
  • Actionable steps for that change and self-stated goals
  • A network of supporters
  • Information gathering and educational availability
  • Personal resourcefulness
  • A level of adaptable/ responsible awareness


Dispositional Optimism and Locus of Control

An interesting study highlighted the effects of positivity on the postoperative outcomes of 51 middle-aged men who had recently undergone heart bypass surgery (Schier, 1989). It may seem obvious to some that thinking positive will likely have positive outcomes. Scientific research outlining the benefits of dispositional optimism and life management of stress is helpful when influencing health engagement from a provider stance.

This particular study was done on patients facing severe health risks. The results proved that dispositional optimism has a positive effect on recovery after a serious health intervention. Patients with dispositional optimism were rated as having faster recovery time by the rehabilitation team working with patients measured in the study.

Dispositional optimism is the term describing an increased ability to handle stress stemming from a person’s ability to have a positive global outlook. This is not the same as blind optimism. Having a general notion that “things will work out” is a state of mind that allows for a person to approach specific problems with a broad view of problem resolution. In stressful situations, problem-based focus exacerbates stress, whereas solution-based focus alleviates stress.

Another interesting scientific study was an experiment on the locus of control in a nursing home (Langer & Rodin, 1976). Patients in the nursing home were divided into two groups based on decision-making capabilities. The first group was given a plant to care for, and decisions around their care were self-determined. The second group was given a plant that a nurse would care for, and the staff of the institution would meet the plant’s every need.

The finding was that patients with an induced sense of personal responsibility had improvements in daily activity and overall happiness. With more personal responsibility, improved mental alertness and behavioral changes were improved. This study showed that even in aging individuals, who face the loss of personal control over health and well being in general, the inducement of any personal control over decision making improved lives.

These studies are significant when considering their impact on increased health engagement. Having dispositional optimism when discussing outcomes of health engagement will likely have effects on improved well being. Besides, having personal choice when pursuing positive health outcomes increases psychological well being and increases personal motivation for behavior change in that pursuit.

Engaging both mental and physical health in a recovery situation is a place of growth for the medical community. The absence of depression and anxiety does not equal mental health. Giving patients information on self-care practices for mental health could be an addition to health engagement that would benefit all patients.


Optimistic Explanatory Style

An optimistic approach to problem-solving does not mean that we have to adhere to the Pollyanna principle. Knowing that a more optimistic explanatory style may increase positive results and decrease stress amid health concerns, can motivate some to change the way they approach their own health. It is possible to learn a more optimistic explanatory style.

The way we speak about what we’re facing is important to our psychological well being, which in turn affects our physical well being. Resilience is built within the realm of realistic and accurate thinking. Nobody wants to face a serious health concern. Nobody wants to feel the pain that comes along with a health concern. The reality is, optimal health is never guaranteed. Words create our worlds, and the development of an optimistic explanatory style can have a strong influence over the outcome when we do face a health concern.

Planning for actionable steps toward improvement in health engagement is one way to utilize this style. A patient may not have absolute control over the outcome of a specific health concern, but they can have control over how their behavior contributes to the desired outcome. Setting clearly defined, actionable steps move patients from learned helplessness to learned hopefulness.

Patients who are personally engaged in the plan for optimal health are more likely to adopt the style of explantation that will most benefit them. Perhaps if patients knew the outcomes of the studies in optimism and pessimism, they might take a more active role in how they think and speak about their health and wellness. Educating patients on mental health and its presence in our physical health is an area of growth in health care.

Most people know that a healthier diet and improvements in exercise can improve their overall wellness. Too few know about the scientific study of positive mental health. Education in this area needs to develop in a collaborative direction.


Value of a Support Network

Studies have shown that isolation, especially in times of stress, is detrimental to one’s well being. The comfort of knowing that you can rely on friends and family when needed is one benefit of developing a network of supporters.

Here are a few more benefits of cultivating a group of people who have your back:

  • Improving coping capabilities
  • Reducing emotional stress when facing adversity
  • Improving self-esteem
  • Lowering blood pressure and other cardiovascular risks
  • Improving adherence to treatment plans
  • Improvements in healthy behaviors
  • Lowering risk of mortality
  • Lowering inflammation
  • Sharing ideas for wellness
  • Increasing accountability for healthy behaviors
  • Increasing those naturally occurring “feel good” hormones and neurotransmitters

Looking at all of these benefits should motivate people to cultivate their support network when times are not stressful, so that network of supporters will be there when times become stressful. All humans face adversity. Knowing people have your back when things get rough is worth the effort in building that network of helpers.

There are many potential pathways to optimal health. Increasing support is one of those pathways (Reblin, 2008). Ask any cancer survivor how supporters played a part in their recovery.


Health Coaching

Support for patients facing serious health concerns can come in the form of a health coach. These are specially trained coaches that serve as an informed confidant to walk the journey toward health alongside a patient. Studies have shown that patients supported by a health coach improve at a much higher rate (Olsen, 2010).

The support can come in a variety of forms and be utilized for a variety of chronic health problems. Evidence has shown that using a coach can improve healthy lifestyle behaviors resulting in a reduction of instances of these chronic diseases. Since 70% of deaths in the United States occur due to chronic diseases, a coaching approach could be the answer to decreasing these stats and increasing the quality of life.

Through a patient-centered approach, health coaches gather educational materials and guide patients on their path toward health goals. Coaches serve patients by providing education, feedback, and support. This support enhances self-awareness, motivation, accountability, and self-efficacy resulting in improved well-being.

A coach would assist a patient in ensuring an increase in health engagement. Having accountability for self-motivated health goals increases the likelihood of reaching those goals. More and more health care providers would benefit from coaching interventions.


Positive Health

In 2008, Martin Seligman proposed a new field, positive health. As in positive psychology, a focus on being well rather than focusing only on eliminating illness was a field to be further explored. He proposed that the World Health Organization concentrates on its Preamble to its Constitution from 1946, which states “Health is a state of complete positive physical, mental, and social well-being, and not merely the absence of disease or infirmity.

Like in positive psychology, a focus on what approaches improve health in the absence of illness was proposed as a way to improve health care in many ways. Reducing health care costs, improving prognosis, and increasing longevity would result from changes being made in this approach to health. Future studies in this area could benefit all areas of health care.

There is an empirical link between positive mental health and positive physical health. The connection and the opportunities for research are far-reaching. Seligman’s notion was to open the genuine possibility that positive mental health and positive physical health are not dichotomous.

Since this groundbreaking proposal, some areas of health care have begun to move toward the vision of exploration of optimal health. With headlines from the United States highlighting the crushing cost of health care, everyone from providers to patients should be intentionally focusing on behavior that increases health engagement. To drive health care costs down, people must be fully committed to their health goals and actively pursue them.

Across the globe, businesses are introducing fitness and nutrition incentives to strengthen their employees and reduce lost time due to illness. With rates of obesity, diabetes, and other chronic diseases soaring, it is this these type of initiatives that will alter the trajectory of health. When people are more actively engaged in their health, optimal health may be achieved.


Personal Responsibility

Education is always a crucial first step in improving an approach to optimal health. A fascinating article in the New England Journal of Medicine (Steinbrook, 2006), outlined some concerns with an initiative in personal responsibility in the state of West Virginia. This initiative was experimenting with Medicaid beneficiaries and personal responsibility to reduce state-wide health care costs.

It brings into question the effectiveness of personal responsibility in populations with limited means or inadequate cognitive capabilities. An overburdened health care system providing care for citizens not taking personal responsibility for their health is indeed problematic and not cost-effective. The trouble lies in how to encourage a population without the means to properly utilize self-care as a pathway to optimal health.

Autonomy in personal decision making is a critical social need and vital in motivation. In a population where the means and abilities are such that fully understanding one’s personal responsibility is assured, measures to improve optimal health can be more easily incentivized. Communities with more limited capabilities prove to be a more difficult area to install change.

Schools and businesses creating endeavors to improve personal responsibility in health engagement have been showing some success. Having the information on how to reduce chronic disease and putting those into action are two separate things. Populations without sufficient financial means to install measures to improve health are likely eye-rolling at the education.

An initiative that might help all populations would be community-wide efforts to educate and practice actions that move humans toward optimal health. Could it be as simple as returning to simplicity? Community gardens, free walking groups, increased volunteerism, and other efforts to unite people in the common goal of improved well being, could be a beneficial change that takes optimal health beyond personal responsibility.

One article suggested that improvements in health care could be within the structure of health care itself (Aveling, 2017). A community-based health care approach has been gaining increased attention. Peer influence is quite powerful in health engagement and should never be underestimated.


A Take-Home Message

Change takes intentional leadership. Looking long and hard at what we don’t want doesn’t always motivate us in the most productive ways. Sedentary lifestyles are creating a massive shift in our well being, and not for the better.

Health engagement is a massive undertaking when viewing its impact on various populations. With varying cultural, socio-economic, and educational awareness, a “one-size fits all” approach will prove to be ineffective. Community involvement and engagement in well being is an incredible space to begin. More leaders taking action to serve their communities is a great place for health engagement to take leaps forward.

More conversations about integrating positive mental health into health engagement need to take place. With scientific research providing so much insight into human motivation, more can be done about engaging people in self-care. Vitality does not happen by accident.

Thanks for reading!


  • Scheier, M. F., Matthews, K. A., Owens, J. F., Magovern, G. J., Lefebvre, R. C., Abbott, R. A., & Carver, C. S. (1989). Dispositional optimism and recovery from coronary artery bypass surgery: The beneficial effects on physical and psychological well-being. Journal of Personality and Social Psychology, 57(6), 1024–1040. doi:10.1037/0022-3514.57.6.1024
  • Seligman, M. E. P. (2008). Positive Health. Applied Psychology, 57(s1), 3–18. doi:10.1111/j.1464-0597.2008.00351.x
  • Olsen, J. M., & Nesbitt, B. J. (2010). Health Coaching to Improve Healthy Lifestyle Behaviors: An Integrative Review. American Journal of Health Promotion, 25(1), e1–e12. doi:10.4278/ajhp.
  • Steinbrook, R. (2006). Imposing Personal Responsibility for Health. New England Journal of Medicine, 355(8), 753–756. doi:10.1056/nejmp068141
  • Aveling, E.-L., Martin, G., Herbert, G., & Armstrong, N. (2017). Optimising the community-based approach to healthcare improvement: Comparative case studies of the clinical community model in practice. Social Science & Medicine, 173, 96–103. doi:10.1016/j.socscimed.2016.11.026
  • Reblin, M., & Uchino, B. N. (2008). Social and emotional support and its implication for health. Current Opinion in Psychiatry, 21(2), 201–205. doi:10.1097/yco.0b013e3282f3ad89

About the Author

Kelly Miller is a graduate of the Flourishing Center’s CAPP program and published author of Jane's Worry Elephant. She is currently the owner of A Brighter Purpose, LLC, a provider in positive psychology coaching services. When she isn’t gleefully helping humans move toward flourishing, she enjoys National Park hikes and spending quality time with her adventurous family.


  1. Margaret Finlay

    Fantastic and succinct assessment of the problems and solutions facing the well-being of the entire human race. Which sounds an overly dramatic summary! But, on consideration, I don’t think it is at all inaccurate. Thank you.

    • Kelly Miller, BA, CAPP

      As more and more people become conscious of the power they have within themselves, the healthier they can become. It’s amazing how what we do every day can change our health for the better.


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