Article Figures & Data
Figures
Tables
Supplemental Tables 1-3; Supplemental Figure
Supplemental Table 1: Prevalence of Individual Risk Behaviors and Risk Behavior Clusters in Entire Sample, n = 864; Supplemental Table 2. Intervention Chosen by Patients With Multiple Behavioral Risks in the Intervention Arm; Supplemental Table 3. Themes and Illustrative Quotations From Interviews With 15 Medical Assistants; Supplemental Figure. Adoption of intervention by medical assistants at 6 primary care clinics.
Files in this Data Supplement:
- Supplemental data: Tables & Figure - PDF file, 4 pages, 144 KB
The Article in Brief
A Medical Assistant-Based Program to Promote Healthy Behaviors in Primary Care
Robert L. Ferrer , and colleagues
Background Most primary care patients have at least one of four major health risk behaviors: smoking, risky drinking, low physical activity, or unhealthy diet. This study sought to determine the effectiveness of a medical assistant-driven program to screen for the unhealthy behaviors, arrange appropriate interventions, and ultimately reduce unhealthy behaviors.
What This Study Found The medical assistant program was much more effective than usual care at linking patients with interventions, more than doubling the proportion of patients referred. Despite the process improvement, however, the program did not succeed in changing any of the four health behaviors.
Implications
- The study results underscore the difficulties in changing health behaviors.
- The authors call for more professional development for medical assistants taking on expanded roles, as well as further work in developing systems to support long-term improvements in patients� behaviors.
Annals Journal Club:
Nov/Dec 2009
Medical Assistants' Role in Improving Preventive and Chronic Illness Care
The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.1How it Works
In each issue, the Annals selects an article or articles and provides discussion tips and questions. We encourage you to take a RADICAL approach to these materials and to post a summary of your conversation in our online discussion. (Open the article online and click on "TRACK Comments: Submit a response.") You can find discussion questions and more information online at: http://www.AnnFamMed.org/AJC/.
CURRENT SELECTION
Articles for Discussion
- Ferrer RL, Mody-Bailey P, Jaen CR, Gott S, Araujo S. A medical assistant-based program to promote health behaviors in primary care. Ann Fam Med. 2009; 7 (6):504-512.
- Gensichen JS, Jaeger C, Peitz M, et al. Health care assistants in primary care depression management: role perception, burdening factors, and disease conception. Ann Fam Med. 2009; 7 (6):513-519.
Discussion Tips
Of the 417,000 medical assistants active in the United States in 2006, 62% worked in physician offices.2 Similar roles exist in other countries. Duties vary but typically are limited to medical care support functions. These 2 articles are relevant to efforts to improve the efficiency and effectiveness of team approaches to primary care by expanding the role of medical assistants. The articles present complementary but contrasting perspectives of chronic illness and preventive care, qualitative and quantitative methods, and US and German social and health care system contexts.Discussion Questions
- What questions are addressed by these articles? How do the questions fit with what already is known on this topic?
- What is the relevance of the research questions for the current economic, practice improvement, and health care system reform efforts?
- How strong are the study designs for answering the questions?
- To what degree can the findings be accounted for by:
- How participants were selected?
- How outcomes were measured?
- Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?
- Researcher bias?
- Chance?
- What are the main findings?
- To what extent do the characteristics of the person performing the expanded role affect how well things work? What evidence do these articles give to support or refute your opinion?
- How comparable are the study populations to your practice? What is your judgment about the transportability of the findings?
- How (if at all) could these studies change your practice?
- What important researchable questions remain?
- What are the implications of the findings for practice improvement and health care reform?
References
- Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4(3):196-197. http://annfammed.org/cgi/content/full/4/3/196.
- Medical assistants. In: Occupational Outlook Handbook, 2008-09 Edition. Bureau of Labor Statistics. http://www.bls.gov/oco/ocos164.htm. Accessed Oct 14, 2009.