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) Supplemental data: Tables & Figure in Brief Journal Club TRACK Discussion: Submit a Comment TRACK Discussion: View Comments 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 Ferrer, R. L. Articles by Araujo, S. Search for Related Content PubMed PubMed Citation Articles by Ferrer, R. L. Articles by Araujo, S. Related Collections Health promotion Quantitative methods Professional practice Organizational / practice change Quality improvement

A Medical Assistant–Based Program to Promote Healthy Behaviors in Primary Care

¹ Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
² Community Medicine Associates, San Antonio, Texas
³ University of New Mexico School of Public Health, Albuquerque, New Mexico

CORRESPONDING AUTHOR: Robert L. Ferrer, MD, MPH, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, FerrerR{at}uthscsa.edu

Annals Journal Club selection—see inside back cover or http://www.annfammed.org/AJC/.

PURPOSE Most primary care patients have at least 1 major behavioral risk: smoking, risky drinking, low physical activity, or unhealthy diet. We studied the effectiveness of a medical assistant–based program to identify and refer patients with risk behaviors to appropriate interventions.

METHODS We undertook a randomized control trial in a practice-based research network. The trial included 864 adult patients from 6 primary care practices. Medical assistants screened patients for 4 risk behaviors and applied behavior-specific algorithms to link patients with interventions. Primary outcomes were improved risk behaviors on standardized assessments. Secondary outcomes included participation in a behavioral intervention and the program’s effect on the medical assistants’ workflow and job satisfaction.

RESULTS Follow-up data were available for 55% of participants at a mean of 12 months. The medical assistant referral arm referred a greater proportion of patients than did usual care (67.4 vs 21.8%; P <.001) but did not achieve a higher success rate for improved behavioral outcomes (21.7 vs 16.9%; P=0.19). Qualitative interviews found both individual medical assistant and organizational effects on program adoption.

CONCLUSION Engaging more primary care team members to address risk behaviors improved referral rates. More extensive medical assistant training, changes in practice culture, and sustained behavioral interventions will be necessary to improve risk behavior outcomes.

Key Words: Practice redesign, behavioral risk factors • medical assistants • primary health care, health promotion • health behavior, allied health occupations

This article has been cited by other articles:

				K. C. Stange Actionable Ideas to Improve Health Care and Health Ann. Fam. Med, January 1, 2010; 8(1): 82 - 84. [Full Text] [PDF]

				L. S. Acheson and J. J. Frey III In This Issue: Multifaceted Research Ann. Fam. Med, November 1, 2009; 7(6): 482 - 483. [Full Text] [PDF]

				Annals Journal Club: Medical Assistants' Role in Improving Preventive and Chronic Illness Care Ann. Fam. Med, November 1, 2009; 7(6): iii - iii. [Full Text] [PDF]

TRACK Comments: