(Part 4/4) Reiterating for Patient Wins

Rome wasn’t built in a day, and neither is our health.

Author

Erika del Pozo MOT, OTR
March 18, 2025

Is dance a sport or an art? Is a hot dog considered a sandwich? Does the weekend begin on Friday or Saturday?!

When it comes to patient engagement, we all know it’s more of an art than a science—but what if it could be both? 

Enter the PEAR Framework, a simple, structured approach to behavior change invented by yours truly and focuses on four key elements: 

  • Priming

  • Educating

  • Activating

  • Reiterating

Why PEAR Works 🍐

The beauty of the PEAR Framework is its simplicity. It’s like the 3-ingredient olive oil, salt, and pepper dressing on a salad that knocks it out of the park. 

It’s adaptable, patient-centered, and crafted to create lasting change by focusing on the how of behavior, not just the what. 🤌

So, whether you directly treat patients or work on patient engagement initiatives in health tech, the PEAR Framework is here to help you make meaningful, sustainable connections.

In the last three newsletter issues, we examined each part of the framework. Now, we are ready to learn about “R” for Reiterating. 

Rome wasn’t built in a day, and neither is our health. 

Health behaviors must be consistently performed to achieve desired outcomes. Many of these behaviors—taking medication as prescribed, sticking to a physical therapy routine, or making dietary changes—require serious planning, effort, motivation, and dedication. 

Without reinforcement, even the best intentions can fade over time.

That’s where Reiteration comes in. 🎉

Reiteration isn’t just about repetition; it’s about reinforcing behaviors, recognizing progress, and making patients feel supported every step of the way. 

Think of it as the cheerleader of patient engagement, helping individuals stay on track and sustain the positive behaviors they’ve worked so hard to implement.

Repetition: The Foundation of Habit Formation

Repetition is fundamental to learning—it structures meaning, enhances understanding, and strengthens habits.

Unlike face-to-face interventions that rely on sporadic check-ins, mobile health (mHealth) interventions offer ongoing, on-demand access to educational materials, reminders, and coaching. This easy and repeated access can lead to long-term, sustained engagement and better health outcomes. (1)

Reinforcement: The Role of Rewards in Behavior Change

Consistency is key to behavior change. Whether it’s following an exercise program for low back pain, taking daily medication for anxiety, or modifying one’s diet to reduce heart disease risk, sustained action is necessary for meaningful results.

In theory, any repeated behavior can become a habit. In practice, the reward associated with the action determines whether the behavior sticks. Research shows that (for better or for worse):

  • Intrinsic rewards (pleasure and satisfaction) are highly motivating.

  • Hedonic rewards (immediate gratification) are more powerful than future-benefit rewards.

  • Delayed rewards (long-term health benefits) have less immediate reinforcement value.

This is why digital health interventions should incorporate small, immediate wins—through gamification, positive feedback, or progress tracking—to help sustain motivation. (2)

Reiteration isn’t just about repetition; it’s about reinforcing behaviors, recognizing progress, and making patients feel supported every step of the way.

Recognition: Strengthening Engagement Through Feedback

Behavior change isn’t a one-and-done process—it requires ongoing support and recognition. Research from the Dresden University of Technology highlights four key attributes of impactful patient engagement tools (3):

  1. Personalization – Tailoring interventions to individual patient needs.

  2. Access to Information – Ensuring patients have the resources to manage their care.

  3. Commitment – Encouraging active patient participation.

  4. Therapeutic Alliance – Building strong provider-patient relationships. (3)

How does this play out in digital health interventions? A few standout strategies include:

  • The Teach-Back Method: This simple yet effective technique ensures understanding. In digital health, it can be integrated through short quizzes that reiterate key learning points.

  • Reminders & Alerts: Push notifications or automated nudges can help reinforce habits and improve adherence to treatment plans.

  • Personalized Feedback: For example, the Run4Love program on WeChat exemplifies this approach by sending weekly progress updates and one-on-one coaching calls at key intervals to encourage continued engagement. (1)

  • Passive Data Collection: Many mHealth platforms leverage wearable devices and app analytics to track user engagement—monitoring steps, sleep, log-ins, and time spent on educational content. This data can be used for process monitoring, quality control, and personalized intervention adjustments. 

The takeaway? 

Reiteration helps patients stay engaged by reinforcing behaviors, providing timely feedback, and acknowledging progress. ✨

What’s Your PEAR Moment?

Ready to implement the PEAR Framework? I’d love to hear how you’re using it to drive behavior change or brainstorm how it can work for your unique challenges.

Let’s stay in touch.

🧠 Unhinged: Thoughts

Ok, I feel like I’ve got wind in my sails again because SPRING IS UPON US. I planted 300+ tulip, daffodil, and crocus bulbs back in October. And now, my very first garden is beginning to bloom 🌱🌷

PS: I’ve been inspired to fine-tune the format of this newsletter to maximize its value for you while making it even more sustainable and productive for me. Stay tuned for the deets. 🙂 

Take care, and see you next time.

Erika

References