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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
Prescription for Health Leads the Way
The New Communication Will Foster Behavior Change
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Morris B. Mellion, Teton Village, WY Assoc MedDir, Blue Bross & Blue Shield Association; Pas Pres, AAFP
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It is well proven that 4 health risk behaviors – smoking tobacco, risky alcohol consumption, unhealthy diet and physical inactivity – cause premature disease, disability and death and massively increase the fiscal burden of health care. What has not been well known is whether systematically applied techniques in contemporary primary care practice can stimulate and assist patients to modify or abort their risky behaviors. This information deficit must be corrected so that both private insures and government payers will have a fiscal interest in funding office based preventive strategies. Prescription for Health (P4H) addresses this challenge directly. Each of the Round 1 P4H papers addresses 2 or more of these risky behaviors. Taken together, they demonstrate that innovative strategies can be effective with feasible modifications in existing primary care practices. They show that a variety of techniques succeed in many diverse demographic and fiscal primary care settings. Moreover, many of the projects prove their success by using both practice and existing community based resources. Even more exciting is the prospect that Round 2 P4H research just getting underway in 10 practice based primary care networks around the country will examine more comprehensive preventive care management strategies for all 4 risky behaviors. By using many common patient selection and program evaluation methods, these projects will learn more about which techniques work best, both in general and in specific populations. Further, analysis by a health economist will identify preliminary information about the incremental cost of the interventions in the existing practice setting. At a time when we intuitively “know” that modifying these behaviors will both improve health and reduce costs, P4H is leading the way to learning what works and how to incorporate it in the existing and future primary care practice settings. Kudos! Morris B. Mellion, M. D. Associate Medical Director, Blue Cross and Blue Shield Association; Past President, American Academy of Family Physicians Competing interests: None declared |
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Joseph E. Scherger, San Diego, CA. USA University of California, San Diego
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Great article in a great supplement. Lifestyle or behavior change offers the largest potential to improve health in primary care practice. I applaud this article's call for redesign of practice to enhance what we already do in today's "real world practice". Let's be more explicit about the redesign possibilities. Continuous comminication through a practice website makes a primary care practice omnipresent in the patient's home. I have all my patients seeking one of the major behavior changes send me a message every week, or more often if desired, to let me know their progress. Positive reinforcement, or coaching, for behavior change takes seconds of my time. This puts the care on a continuous platform. Of course research will need to be done to demonstrate just how effective web based communication can be in behavior change. One active area of research is the development of web based tools for behavior change(1). 1: Stoddard J, Delucchi K, Munoz R, Collins N, Stable EP, Augustson E, Lenert L. Smoking cessation research via the internet: a feasibility study. J Health Commun. 2005 Jan-Feb;10(1):27-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15764442&query_hl=2 Competing interests: None declared |
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