Article Figures & Data
Figures
- Figure 1.
Geographic distribution of Prescription for Health practice-based research networks.
- Figure 2.
Integration of health behavior change strategies in primary care.
Tables
PBRN Behaviors Addressed Target Population Activation Point Tools Techniques PBRN = practice-based research network; PDA = personal digital assistant (ie, handheld computers); 5 A’s = ask, advise, agree, assist, arrange; BMI = body mass index; UCSF = University of California at San Francisco. Alabama Practice Based Research Network (APBRN) Diet, tobacco Adult Clinician PDA, health advisor/coach 5 A’s, motivational interviewing, goal setting/action plan, community links, e-mail follow-up Clinicians Enhancing Child Health (CECH) Activity, diet, tobacco, drinking Adolescent (12–18 years) Clinician, patient PDA, health advisor/coach, educational materials, patient assessment/screen 5 A’s, motivational interviewing, goal setting/action plan, community links, e-mail follow-up, clinician training Colorado Research Network (CaReNet), High Plains Research Network (HPRN) Activity, diet Adult Clinician, staff, patient Pedometer, patient assessment/screen, activity/nutrition logs, prescription pad Clinician/staff modeling of behavior change, goal setting/action plan, telephone follow-up Dartmouth-Northern New England COOP Project Activity, diet, tobacco, drinking Adult Patient, practice, health plan, community Web site, registry, patient assessment/screen, vital signs 5 A’s, goal setting/action plan, community links, group visits, telephone follow-up, e-mail follow-up, motivational interviewing Great Lakes Research Into Practice Network (GRIN) Activity, diet, tobacco, drinking Adult Practice, nurseconsultant Practice assessment, consultant 5 A’s, practice consultation, goal setting/action plan Kentucky Ambulatory Network (KAN) Activity, tobacco Adult Patient Prescription pad, health advisor/coach, activity/nutrition logs, educational materials, patient assessment/screen Community program, goal setting/action plan, telephone follow-up Midwest Nursing Centers Consortium Research Network (MNCCRN) Activity, diet Adult Clinician, patient Pedometer, nutrition/activity logs, health advisor/coach, patient assessment/screen Group visits, goal setting/action plan, community links, telephone follow-up Minnesota Academy of Family Physicians Research Network (MAFPRN) Activity, diet, tobacco, drinking Adult Patient, staff Web site, health advisor/coach, educational materials, vital signs, patient assessment/screen Motivational interviewing, community links, telephone follow-up, e-mail follow-up, clinician training, external personnel New England Clinicians Forum (NECF) Tobacco, drinking Adult Clinician, staff Health advisor/coach, educational materials, vital signs, patient assessment/screen Brief intervention, scheduled follow-up visit, clinician training Northwest Ohio Primary Care Research Network (NOPCRN) Activity, diet Adult Clinician, patient PDA, pedometer, activity/nutrition logs, patient assessment/screen Goal setting/action plan, telephone follow-up, clinician training Pediatric PitNet Activity, diet Children (8–12 years) Clinician, staff, parent BMI chart, health advisor/coach, vital signs, educational materials, activity/nutrition logs, patient assessment/screen Motivational interviewing, community links, goal setting/action plan, group visits, clinician training Pediatric Practice Research Group (PPRG) Activity, diet Children (2–10 years) Practice, patient, parent PDA, wall chart, educational materials, vital signs, patient assessment/screen, practice assessment Practice consultation, clinician training Penn State Ambulatory Research Network (PSARN) Activity, diet Adult Staff, patient Health advisor/coach, registry, educational materials, patient assessment/screen Motivational interviewing, goal setting/action plan, community links, telephone follow-up, e-mail follow-up, external personnel Research Association of Practices (RAP) Activity, diet, tobacco, drinking Adult Clinician, staff, patient Web site, prescription pad, educational materials, patient assessment/screen, practice assessment Motivational interviewing, community links Virginia Ambulatory Care Outcomes Research Network (ACORN) Activity, diet, tobacco, drinking Adult Clinician, patient Web site, patient assessment/screen, educational materials Community links Virginia Practice Support and Research Network (VaPSRN) Diet, tobacco Adult and adolescent Clinician PDA, vital signs, patient assessment/screen, practice assessment Motivational interviewing UCSF/Stanford Collaborative Research Network (CRN) Activity, diet, tobacco Adult Clinician Patient assessment/screen Goal setting/action plan, clinician training, external personnel - Table 2.
Strategies Implemented by Prescription for Health Projects by Domain of the Chronic Care Model
Domain Implementation Strategies PDA = personal digital assistant (ie, handheld computer). Community resources Locally based community health advisors Web-based directories of community resources Web links to relevant information or resources outside community (regional or national) Health care organization Practicewide assessments Clinician assessments (attitudes, satisfaction, readiness to change) Evaluation of use of specific tools or techniques Negotiated support from insurers for project activities Self-management support Patient-centered goal setting and action plans Motivational interviewing techniques Physical activity and dietary logs Community resource directories Local walking club Periodic follow-up from health change facilitators, educators, or advisors Telephone and e-mail follow-up and support Pedometers Tailored behavior change educational materials or information Delivery system design Patient questionnaires before visit and ongoing (Web-based) Staff role changes and education Health advisors, educators, coaches/health change facilitators Brief interventions Periodic health assessments (vital signs and others) Prescription pads for health behaviors Group visits Telephone and e-mail follow-up support Decision support Patient-reported health behavior information (before, during, and between visits) Relevant preventive services guidelines Patient readiness-to-change assessments Streamlined evidence-based assessment and screening tools Tailored scripts and techniques Patient-tailored care recommendations Targeted evidence-based recommendations Electronic (Web, PDA) decision-support tools Clinical information systems Patient registries Reminder systems (electronic, posters, assessments, patient-reported behavior indicators, other) Patient-completed screening tools Logs and behavioral questionnaires Expanded vital signs to include risky health behaviors
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Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors
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