HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) TRACK Discussion: Submit a Comment Alert me when this article is cited Alert me when TRACK Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cohen, D. J. Articles by Young, D. M. Search for Related Content PubMed PubMed Citation Articles by Cohen, D. J. Articles by Young, D. M. Related Collections Health promotion Qualitative methods Health policy PBRN research Organizational / practice change

Implementing Health Behavior Change in Primary Care: Lessons From Prescription for Health

Department of Family Medicine, University of Medicine and Dentistry, Robert Wood Johnson Medical School, Somerset, NJ

CORRESPONDING AUTHOR: Deborah J. Cohen, PhD, Department of Family Medicine, University of Medicine and Dentistry, Robert Wood Johnson Medical School, 1 Worlds Fair Dr, Somerset, NJ 08803, debbiec{at}nac.net

PURPOSE Our objective was to identify themes that emerged from the evaluation of 17 interventions funded by the Robert Wood Johnson Foundation’s Prescription for Health that aimed to enhance adherence to healthy behaviors in the primary care setting.

METHODS We performed a content analysis of diary data from this 16-month initiative. Other data sources used to complement this analysis include funded grant applications and field notes from interviews with investigative teams and a limited number of site visits. Participants were 17 practice-based research networks (PBRNs) that had projects funded during Round 1 of Prescription for Health.

RESULTS Five themes emerged regarding implementation of health behavior change: (1) health behavior change resources are enthusiastically received by practices and patients, and when given a choice, patients prefer methods of assistance that involve personal contact; (2) practice extenders require extensive training, as well as careful case management and support, in order to function fully and avoid burnout; (3) integrating behavior change tools into the primary care setting requires time, effort, and often specialized expertise; (4) even simple interventions require practice change, and use of a practice change model to guide implementation efforts is crucial; and (5) research philosophy and project management approaches vary across PBRNs and have implications for the potential sustainability of an intervention.

CONCLUSIONS A more versatile, multifaceted solution involving new tools, technologies, and multidisciplinary care teams is needed in order to integrate health behavior change into everyday primary care routines. Even the best interventions require a model to articulate how to integrate an innovation into practices.

Key Words: Behavior • health behavior • health promotion/disease prevention • practice-based research • practice of medicine • health care delivery • primary care

This article has been cited by other articles:

				M. Cifuentes, D. H. Fernald, L. A. Green, L. J. Niebauer, B. F. Crabtree, K. C. Stange, and S. B. Hassmiller Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors Ann. Fam. Med, July 1, 2005; 3(suppl_2): S4 - S11. [Abstract] [Full Text] [PDF]