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Research ArticleCross-Project Analyses

Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors

Maribel Cifuentes, Douglas H. Fernald, Larry A. Green, Linda J. Niebauer, Benjamin F. Crabtree, Kurt C. Stange and Susan B. Hassmiller
The Annals of Family Medicine July 2005, 3 (suppl 2) S4-S11; DOI: https://doi.org/10.1370/afm.378
Maribel Cifuentes
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Douglas H. Fernald
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Larry A. Green
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Linda J. Niebauer
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Benjamin F. Crabtree
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Kurt C. Stange
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Susan B. Hassmiller
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  • Prescription for Health Leads the Way
    Morris B. Mellion
    Published on: 17 August 2005
  • The New Communication Will Foster Behavior Change
    Joseph E. Scherger
    Published on: 03 August 2005
  • Published on: (17 August 2005)
    Page navigation anchor for Prescription for Health Leads the Way
    Prescription for Health Leads the Way
    • Morris B. Mellion, Teton Village, WY

    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 behavior...

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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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    Competing Interests: None declared.
  • Published on: (3 August 2005)
    Page navigation anchor for The New Communication Will Foster Behavior Change
    The New Communication Will Foster Behavior Change
    • Joseph E. Scherger, San Diego, CA. USA

    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 patie...

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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

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 3 (suppl 2)
The Annals of Family Medicine
Vol. 3, Issue suppl 2
1 Jul 2005
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Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors
Maribel Cifuentes, Douglas H. Fernald, Larry A. Green, Linda J. Niebauer, Benjamin F. Crabtree, Kurt C. Stange, Susan B. Hassmiller
The Annals of Family Medicine Jul 2005, 3 (suppl 2) S4-S11; DOI: 10.1370/afm.378

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Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors
Maribel Cifuentes, Douglas H. Fernald, Larry A. Green, Linda J. Niebauer, Benjamin F. Crabtree, Kurt C. Stange, Susan B. Hassmiller
The Annals of Family Medicine Jul 2005, 3 (suppl 2) S4-S11; DOI: 10.1370/afm.378
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  • Outcomes of Biomarker Feedback on Physical Activity, Eating Habits, and Emotional Health: From the Americans in Motion-Healthy Intervention (AIM-HI) Study
  • Improving Multiple Health Risk Behaviors in Primary Care: Lessons from the Prescription for Health COmmon Measures, Better Outcomes (COMBO) Study
  • The Role of the Champion in Primary Care Change Efforts: From the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP)
  • Intraclass Correlation Coefficients Typical of Cluster-Randomized Studies: Estimates From the Robert Wood Johnson Prescription for Health Projects
  • The Rural Older Adult Memory (ROAM) Study: A Practice-based Intervention to Improve Dementia Screening and Diagnosis
  • Practice Benefit from Participating in a Practice-based Research Network Study of Postpartum Depression: A National Research Network (NRN) Report
  • Measuring Primary Care Expenses
  • A Medical Assistant-Based Program to Promote Healthy Behaviors in Primary Care
  • Strategies for Incorporating Antimicrobial Mouthrinses into Daily Oral Care
  • A Practice-Sponsored Web Site to Help Patients Pursue Healthy Behaviors: An ACORN Study
  • Practice-Based Research in Primary Care: Facilitator of, or Barrier to, Practice Improvement?
  • Putting It Together: Finding Success in Behavior Change Through Integration of Services
  • In This Issue: Patient Outcomes, the Process of Care, and the Capacity for Innovation
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More in this TOC Section

  • Implementing Health Behavior Change in Primary Care: Lessons From Prescription for Health
  • Practice-Based Research in Primary Care: Facilitator of, or Barrier to, Practice Improvement?
Show more Cross-Project Analyses

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Subjects

  • Domains of illness & health:
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  • Methods:
    • Qualitative methods
  • Other research types:
    • PBRN research
  • Other topics:
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