Table 2.

Strategies Implemented by Prescription for Health Projects by Domain of the Chronic Care Model

DomainImplementation Strategies
PDA = personal digital assistant (ie, handheld computer).
Community resourcesLocally based community health advisors
 Web-based directories of community resources
 Web links to relevant information or resources outside community (regional or national)
Health care organizationPracticewide 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 supportPatient-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
 Tailored behavior change educational materials or information
Delivery system designPatient 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 supportPatient-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 systemsPatient 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