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Table 3 Summary of CMO configurations

From: A realist review of shared medical appointments: How, for whom, and under what circumstances do they work?

CMOc Subsection Context + Mechanism = Outcome
1. Combats Isolation Isolation Social contact (resource) → Correcting misperceptions(response) Likely improved in self-efficacy
2. Vicarious Learning Isolation Exposure to others’ illness (resource) → gaining perspective on one’s illness situation (response) Likely improved self-efficacy
3. Feeling inspired by successful peers Low/high motivation for self-management behavior Exposure to others’ successes (resource) → trying to emulate success (response) Likely improved self-efficacy
4. Friendships develop between patients and providers SMAs are more relaxed than one-on-one clinical encounters New patient-provider friendships developed (resource) → fostering trust amongst all parties (response) Likely improved motivations and self-efficacy
5. Improved collegiality amongst providers Providers typically work in isolation Team members are able to witness and interact (resource) → leading to mutual appreciation of respective roles and bonding (response) Likely improved service delivery and work satisfaction
6. Provider learning Providers unaware of patient needs Group setting encouraged creative thinking about meeting people’s needs Likely improved service delivery
7. Adequate time allotment SMAs are longer sessions than one-on-one clinical visits Allows patients and providers to get to know each other, relax (resource) → leads to a sense of comfort for the patient (response) Likely improved self-management
8. First-hand health knowledge Isolation Group visit allows patients to share, confirm/dispute information (resource) → leads to patients feeling reassured about health knowledge provided (response) Likely improved application of information given
9. Increased trust in physician Mistrust of physicians a common experience in healthcare SMA creates more even power dynamics between patient and provider (resource) → leads to patient feeling increased trust in physician (response) Improved doctor-patient relationship and likely improved self-efficacy
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