Health expectations: an international journal of public participation in health care and health policy Impact Factor & Information

Publisher: Wiley

Journal description

Do patients want to participate in treatment decisions? What is the best way to determine the views of health service users? What can governments do to engage citizens in setting priorities? What factors influence the demand for health care?Health Expectations aims to promote critical thinking and informed debate about all aspects of public participation in health care and health policy, including: involvement of patients and their advocates in decisions about individual health care; involvement of health service users and their representatives in aspects of service design, delivery and evaluation; involvement of the general public in debates about health care policy.

Current impact factor: 2.85

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.852
2012 Impact Factor 2.11
2011 Impact Factor 2.315
2010 Impact Factor 2.315
2009 Impact Factor 1.803
2008 Impact Factor 2.397
2007 Impact Factor 1.949
2006 Impact Factor 2.089

Impact factor over time

Impact factor

Additional details

5-year impact 0.00
Cited half-life 5.60
Immediacy index 0.68
Eigenfactor 0.00
Article influence 0.77
Website Health Expectations website
Other titles Health expectations (Online)
ISSN 1369-7625
OCLC 45266670
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • Non-Commercial
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Given the rapid increase of Internet use for effective health communication, it is important for health practitioners to be able to identify and mobilize active users of online health information across various web-based health intervention programmes. We propose the concept 'health e-mavens' to characterize individuals actively engaged in online health information seeking and sharing activities. This study aimed to address three goals: (i) to test the factor structure of health e-mavenism, (ii) to assess the reliability and validity of this construct and (iii) to determine what predictors are associated with health e-mavenism. This study was a secondary analysis of nationally representative data from the 2010 Health Tracking Survey. We assessed the factor structure of health e-mavenism using confirmatory factor analysis and examined socio-demographic variables, health-related factors and use of technology as potential predictors of health e-mavenism through ordered regression analysis. Confirmatory factor analyses showed that a second-order two-factor structure best captured the health e-maven construct. Health e-mavenism comprised two second-order factors, each encompassing two first-order dimensions: information acquisition (consisting of information tracking and consulting) and information transmission (consisting of information posting and sharing). Both first-order and second-order factors exhibited good reliabilities. Several factors were found to be significant predictors of health e-mavenism. This study offers a starting point for further inquiries about health e-mavens. It is a fruitful construct for health promotion research in the age of new media technologies. We conclude with specific recommendations to further develop the health e-maven concept through continued empirical research. © 2015 The Authors. Health Expectations. Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12398
  • [Show abstract] [Hide abstract]
    ABSTRACT: Health communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. However, growing numbers of e-patients use the Internet to equip themselves with specialized biomedical knowledge that is couched in medical terms, which they then share on participatory media, such as online patient forums. Given possible discrepancies between preconceptions about the kind of language that patients can understand and the terms they may actually know and use, the purpose of this paper was to investigate medical terminology used by patients in online patient forums. Using data from online patient-patient communication where patients communicate with each other without expert moderation or intervention, we coded two data samples from two online patient forums dedicated to thyroid issues. Previous definitions of medical terms (dichotomized into technical and semi-technical) proved too rudimentary to encapsulate the types of medical terms the patients used. Therefore, using an inductive approach, we developed an analytical framework consisting of five categories of medical terms: dictionary-defined medical terms, co-text-defined medical terms, medical initialisms, medication brand names and colloquial technical terms. The patients in our data set used many medical terms from all of these categories. Our findings suggest the value of a situated, condition-specific approach to health literacy that recognizes the vertical kind of knowledge that patients with chronic diseases may have. We make cautious recommendations for clinical practice, arguing for an adaptive approach to medical terminology use with patients. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12395
  • [Show abstract] [Hide abstract]
    ABSTRACT: Whilst there has been a focus on the importance of social support for managing long-term conditions, there has been little specific focus on the characteristics of social networks that shape self-management. Policy emphasis is placed on individual responsibility for self-care, and this influences commissioning of health-care services. Assumptions are often made by policymakers about accessibility and preference for support and the influence of the social context on chronic illness management. To examine the social networks of individuals with long-term conditions and identify how the characteristics of their composition influences support needs. Thirty participants completed initial face-to-face in-depth interviews, telephone follow-ups and final face-to-face interviews in the north-west of England. A longitudinal qualitative design was used to elicit the subtle changes in relationships over a year. The findings suggest that the relationships which constitute a social network influence perceived support needs and attitudes to self-management. The amalgamation of relationships was characterized into three network typologies (family focused, friend focused or health-care professional focused) according to which types of relationships were dominant. In the absence of support, accounts highlighted a small number of substitutes who could provide support at times of critical need. This study challenges the notion of 'self'-management as an individual construct as many of the practices of illness management involved the support and/or negotiation of roles with others. By examining the nuances of relationships, this study has highlighted the tacit boundaries of practical and emotional support provision. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12394
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore the perceptions of health professionals in an integrated network of public provision of health services regarding the implementation of the Law on Rights and Duties of People in Chile. Qualitative descriptive study. A stratified qualitative sample of 53 professionals from five low complexity centres and one from a high complexity centre, all part of the integrated network of health services in Valdivia, Los Rios Region, Chile, were selected according to the criteria of an overall saturation of the explored dimensions. The information was gathered through a semi-structured, in-depth interview carried out after signing the informed consent. Data were analysed using an inductive approach of content analysis. Three categories emerged from the interviews: conceptualization and knowledge, factors influencing the implementation and recommendations for strengthening the implementation, and seven subcategories. It was highlighted that health professionals in the health-care network perceived difficulties in implementing the Law on rights and duties of patients. Among them were the lack of knowledge about the Law, poor exposure and a lack of resources for its implementation. They suggested adapting the infrastructure of the institution and offering training as recommendations to improve the implementation of the Law. There are hindering factors for the implementation of the Law related to organizational and professional gaps in the institutions providing health care. © 2015 The Authors. Health Expectations. Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12396
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients with severe aortic stenosis (AS) at high risk for aortic valve replacement are a unique population with multiple treatment options, including medical therapy, surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR). Traditionally, in elderly populations, goals of treatment may favour quality of life over survival. Professional guidelines recommend that clinicians engage patients in shared decision making, a process that may lead to decisions more aligned with patient-defined goals of care. Goals of care for high-risk patients with AS are not well defined in the literature, and patient-reported barriers to shared decision making highlight the need for explicit encouragement from clinicians for patient involvement. The purpose of this study was to elicit and report patient-defined goals from elderly patients facing treatment decisions for severe AS. This analysis was conducted at Dartmouth-Hitchcock Medical Center, an academic medical institution. In a retrospective manner, we qualitatively analysed goal statements reported by high-risk, elderly patients with severe AS evaluated for TAVR between June 2012 and August 2014. Forty-six patients provided treatment goals during consideration of TAVR and defined preferred outcomes as maintaining independence, staying alive, reducing symptoms or, most commonly, increasing their ability to do a specific activity or hobby. In the high-risk patient population considering TAVR, patient-reported goals may be obtained with a simple question delivered during the clinical encounter. Encouraging patients to define their goals may lead to a greater degree of shared decision making, as advocated in current professional guidelines. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12393
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mental health care has lagged behind other health-care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self-management and recovery-oriented practice, and growing policy-level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs. This conceptual review argues that several aspects of mental health care that differ from other health-care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health-care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro-social focus of a medical consultation. Contextualizing specific medication-related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM. A broad conceptualization of decision making for psychiatric medication that moves beyond the micro-social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12392
  • Katie L. Hackett · Rebecca L. Lambson · Victoria Strassheim · Zoe Gotts · Vincent Deary · Julia L Newton
    [Show abstract] [Hide abstract]
    ABSTRACT: ImportanceFatigue is a significant and debilitating symptom affecting 25% of the population. It occurs in those with a range of chronic diseases, can be idiopathic and in 0.2–0.4% of the UK population occurs in combination with other symptoms that together constitute chronic fatigue syndrome (CFS). Until recently, NHS clinical services only focussed upon CFS and excluded the majority of fatigued patients who did not meet the CFS diagnostic criteria. The CRESTA Fatigue interdisciplinary clinic was established in 2013 in response to this unmet need.Objective To identify the service needs of the heterogeneous group of patients accessing the CRESTA Fatigue Clinic, to prioritize these needs, to determine whether each is being met and to plan targeted service enhancements.DesignUsing a group concept mapping approach, we objectively identified the shared understanding of service users accessing this novel clinic.SettingNHS Clinics for Research & Service in Themed Assessment (CRESTA) Fatigue Clinic, Newcastle Upon Tyne, UK.ParticipantsPatients (n = 30) and referrers (n = 10) to the CRESTA Fatigue Clinic contributed towards a statement generation exercise to identify ways the clinic could support service users to improve their quality of life. Patients (n = 46) participated in the sorting and rating task where resulting statements were sorted into groups similar in meaning and rated for ‘importance’ and ‘current success’.Main outcome and measureWe mapped the needs of patients attending the CRESTA Fatigue Clinic and identified which high-priority needs were being successfully met and which were not.ResultsMultidimensional scaling and hierarchical cluster analysis depicted the following eight themed clusters from the data which related to various service-user requirements: ‘clinic ethos’, ‘communication’, ‘support to self-manage’, ‘peer support’, ‘allied health services’, ‘telemedicine’, ‘written information’ and ‘service operation’. Service improvement targets were identified within value bivariate plots of the statements.Conclusion and RelevanceService development concepts were grouped into thematic clusters and prioritized for both importance and current success. The resulting concept maps depict where the CRESTA Fatigue Clinic successfully addresses issues which matter to patients and highlights areas for service enhancement. Unmet needs of patients have been identified in a rigorous service evaluation, and these are currently being addressed in collaboration with a service-user group.
    Health expectations: an international journal of public participation in health care and health policy 08/2015; DOI:10.1111/hex.12405
  • Health expectations: an international journal of public participation in health care and health policy 08/2015; 18(4):451. DOI:10.1111/hex.12377
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over-the-counter (OTC) labels help support safe medication use by consumers. In 2012, the Australian Therapeutic Goods Administration (TGA) released a consultation paper proposing OTC label standardization to improve label quality via implementation of the Medicine Information Box (MIB) label. However, consumer opinions of the MIB and standardization of OTC labelling remain unexplored. To explore consumer perspectives of OTC label standardization and the proposed MIB. Mock MIB labels were developed by the research team, guided by the TGA consultation paper, and used as interview stimulus material. Semi-structured interviews were conducted with 38 Australian and 39 UK adult participants. Participant perspectives on OTC label standardization, opinions on the MIB and perceived improvements were explored. All interviews were audio-recorded with permission, transcribed verbatim, and the content thematically analysed. Participants expressed a range of opinions towards OTC label standardization, from welcoming standardization to concern that important details may be overlooked. The MIB was generally positively received due to its perceived good information design and ease of navigation. Participants requested reordering of information-specifically, for the active ingredient to be moved to a less prominent position. Suggested improvements centred on content and design changes, for example colour, pictograms, bolding. Participants felt positively towards OTC label standardization and saw the MIB as a feasible standardized format to implement for OTC labels. Although they appreciated its good information design, they felt further improvements to its content and design are required to enhance its quality and usability. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12389
  • [Show abstract] [Hide abstract]
    ABSTRACT: There exist no recommendations as to how aggregate research results should best be disclosed to long-term cohort participants. To study the impact of cohort results disclosure documents of various kinds on participants' satisfaction. Randomized study with a 2x2 factorial design. The GENEPSO-PS cohort is used to study the psychosocial characteristics and preventive behaviour of both BRCA1/2 carriers and non-carriers; 235 participants wishing to receive 'information about the survey results' answered a self-administered questionnaire. The impact of providing the following items in addition to a leaflet about aggregate psychosocial research results was investigated (i) an up-to-date medical information sheet about BRCA1/2 genetic topics, (ii) a photograph with the names of the researchers. Satisfaction profiles drawn up using cluster analysis methods. Providing additional medical and/or research team information had no significant effect on satisfaction. The patients attributed to the 'poorly satisfied' group (n = 60, 25.5%) differed significantly from those in the 'highly satisfied' group (n = 51, 21.7%): they were younger [odds ratio (OR) = 0.96, 95% confidence interval (0.92-0.99), P = 0.028], less often had a daughter [OR = 4.87 (1.80-13.20), P = 0.002], had reached a higher educational level [OR = 2.94 (1.24-6.95), P = 0.014] and more frequently carried a BRCA1/2 mutation [OR = 2.73 (1.20-6.23), P = 0.017]. This original approach to disclosing research results to cohort participants was welcomed by most of the participants, but less by the more educated and by BRCA1/2 carriers. Although an easily understandable document is necessary, it might also be worth providing some participants with more in-depth information. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12390
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. Cross-sectional population-based survey. We conducted this study in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi-stage stratified cluster sampling process. We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio-demographic and outcome variables. Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter-menstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12382
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patient question-asking is essential to shared decision making. We sought to describe patients' questions when faced with cancer prevention and screening decisions, and to explore differences in question-asking as a function of health literacy with respect to spoken information (health literacy-listening). Four-hundred and thirty-three (433) adults listened to simulated physician-patient interactions discussing (i) prophylactic tamoxifen for breast cancer prevention, (ii) PSA testing for prostate cancer and (iii) colorectal cancer screening, and identified questions they would have. Health literacy-listening was assessed using the Cancer Message Literacy Test-Listening (CMLT-Listening). Two authors developed a coding scheme, which was applied to all questions. Analyses examined whether participants scoring above or below the median on the CMLT-Listening asked a similar variety of questions. Questions were coded into six major function categories: risks/benefits, procedure details, personalizing information, additional information, decision making and credibility. Participants who scored higher on the CMLT-Listening asked a greater variety of risks/benefits questions; those who scored lower asked a greater variety of questions seeking to personalize information. This difference persisted after adjusting for education. Patients' health literacy-listening is associated with distinctive patterns of question utilization following cancer screening and prevention counselling. Providers should not only be responsive to the question functions the patient favours, but also seek to ensure that the patient is exposed to the full range of information needed for shared decision making. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12387
  • [Show abstract] [Hide abstract]
    ABSTRACT: In western societies, a shared decision-making model for doctor-patient relationships calling for open and collaborative communication is recommended. Research focuses mainly on the doctor's communication patterns, while research on patient communication patterns is rare. The purpose of this study was to develop a tool for evaluating patient's communication patterns - the Patient Communication Pattern Scale (PCPS). Interviews based on structured questionnaires were conducted with 251 cancer patients. In addition to the 14-item PCPS, the questionnaire included questions regarding education, religiosity and desirability of control in general and over one's own health in particular, for validating the scale. The PCPS was found to be a valid and reliable tool for evaluating patients' communication patterns. Confirmatory factor analysis supported the PCPS designed structure of five facets: (1) Information, (2) Clarification, (3) Initiation, (4) Preferences and (5) Emotions. The PCPS is a reliable scale for evaluating patient communication patterns. The use of this scale can assist in promoting related research and in developing interventions for enhancing open and collaborative doctor-patient communication. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12381
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Adolescent obesity is a complex condition involving social, emotional, behavioural and cultural issues.DesignOne-to-one interviews and small focus groups with overweight and obese young people were conducted. Qualitative research is an appropriate method to explore the complexity of this issue.Setting and participantsOverweight and obese adolescent's attending a community weight management intervention in South Yorkshire.Main variables studiedInterviews aimed to explore the experiences of obese adolescents and their perspectives towards obesity treatment.ResultsAdolescent's provided detailed accounts of their perspectives on weight gain, alluding to disordered patterns of eating and overeating, reported as being triggered by social and emotional factors, and in particular, bullying. Avoidance of bullying and a desire to integrate socially with peers were key drivers to seek treatment. Young people reported what they should do to lose weight, yet responsibility for successful weight loss and lifestyle change was repeatedly attributed to the treatment received, as opposed to viewing this as a combination of self-motivation coupled with support provided by friends and family.Conclusion Weight loss programmes need to consider the complex experience of obese young people in their design, focusing on how to implement long-term lifestyle changes.
    Health expectations: an international journal of public participation in health care and health policy 07/2015; DOI:10.1111/hex.12385