FOR IMMEDIATE RELEASE
FRIDAY, MARCH 24, 2006, 8 AM PST
Contact: Amy Stone
Phone: (414) 918-3156
Changing Behavior by Changing Primary Care Practices
(San Francisco, Mar. 24, 2006) - A lay health coach in a primary care setting? Restructuring of the adolescent wellness visit? A web-based resource of community programs?
These innovative approaches to changing behavior in primary care practices were presented today by Maribel Cifuentes, RN and her colleagues at the Society of Behavioral Medicine Annual Meeting and Scientific Sessions. Cifuentes is Deputy Director of Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks, a national initiative of the Robert Wood Johnson Foundation administered by the University of Colorado Health Sciences Center, Department of Family Medicine
As part of Prescription for Health, 17 projects were implemented in 120 family medicine, internal medicine, pediatric, and nursing practices across an ethnically diverse sample of adults, adolescents, and children in rural and urban settings. The funded projects confirm the feasibility and need of health behavior counseling in primary care practice for problems such as obesity, weight management, and management of chronic diseases like diabetes.
RESTRUCTURING THE ADOLESCENT WELL-VISIT
One project evaluated tools to increase screening and enhance counseling during adolescent well-visits among 11-19 year-old adolescents in New Hampshire and Vermont. The project was lead by Cecilia A. Gaffney, M.Ed. and colleagues at Dartmouth Medical School.
The three tools to facilitate counseling were: (1) a PDA-based adolescent health history and risk behavior screener; (2) action plan handout; and (3) e-mail follow-up. These resulted in increases in discussion of fruit/vegetable intake (45% to 63%) as well as tobacco use (43% to 60%) and alcohol use (41% to 58%).
COMMUNITY HEALTH PROMOTION
Another study designed by Susan Flocke, PhD and colleagues at Case Western Reserve University investigated if primary care physicians' ability to provide effective health behavior change advice might be leveraged by linking to available community resources. The study was developed to assist Ohio primary care physicians in counseling adults about lifestyle changes. Physicians were provided a web-based health behavior change resource including a database of community programs and patient education materials, and a health behavior prescription pad.
Access to these resources resulted in increased rates of discussion of diet (from 20.2% to 25.7%), exercise (from 16.9% to 27.8%) and weight management (from 16.3% to 23.2%). It also led to increased referrals to patient education materials (from 21.6% to 24.2%) and community programs for health behavior change (from 13.6% to 16.0%).
"These changes were all the more impressive because evaluation of qualitative field notes suggests the intervention was not appreciably implemented in 6 of 7 participating practices," Flocke commented.
CAN A LAY HEALTH COACH HELP?
Another study by Alan M. Adelman, MD, and colleagues from Penn State University addressed the limited training and resources of most primary care clinicians for addressing lifestyle changes. This project incorporated a lay health coach into office practices in Pennsylvania to assist patients in lifestyle changes.
Patients at least 18 years old with BMI > 30 were linked to a lay health coach trained in motivational techniques. "The lay health coach assisted participants to address physical inactivity and/or poor eating habits and provided follow-up. Participants also received My Health Habits Journal to aid in changing their effort," commented Adelman.
Seventy one percent of subjects lost weight, with average loss of 1.62 kg (p < .05). Sixty seven percent increased fruit/vegetable intake. Participants were 2.5 times more likely to show improvement in physical activity scores post-intervention. Thus, a lay health coach in primary care offices was feasible and successful in producing improvements in physical activity, eating habits, and weight.
For more information about Prescription for Health, visit www.prescriptionforhealth.org.
What is Behavioral Medicine?
Behavioral medicine is the multidisciplinary field concerned with the behavioral and social aspects of medical conditions. Consumers and a wide variety of health professionals are involved in behavioral medicine research and practice, including cardiologists, counselors, epidemiologists, exercise physiologists, family physicians, health educators, internists, nurses, nutritionists, pediatricians, psychiatrists, and psychologists. Behavioral medicine takes a life-span approach to health and health care, working with children, teens, adults, and seniors individually and in groups, and working with racially and ethnically diverse communities in the United States and abroad.
Founded in 1978, SBM has more than 2,000 members and provides the many disciplines of behavioral health care with an interactive network of education and collaboration on common research, clinical, and public policy concerns related to prevention, diagnosis, treatment, rehabilitation and health promotion. For more information, visit www.sbm.org.
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