Table 1.

Interventions Evaluated in Prescription for Health Projects, by Counseling Step

4. More Intensive Assistance (Assist)
PBRN1. Identify Behaviors and Health Conditions (Assess)2. Brief Advice/Training (Advise)3. Goal Setting (Agree)InformationCounselingSelf-Management5. Reinforcement, Follow-up (Arrange)
Note: The contents of this table were reviewed and edited by investigators from each of the 17 Prescription for Health projects.
*Interventions at GRIN practices varied and were determined and implemented individually by practices.
5 A’s = assess, advise, agree, assist, arrange; ACORN = Virginia Ambulatory Care Outcomes Research Network; APBRN = Alabama Practice Based Research Network; BMI = body mass index; BP = blood pressure; CaReNet = Colorado Research Network; CECH = Center to Enhance Child Health Network; CRN = University of California at San Francisco (UCSF)/Stanford Collaborative Research Network; COOP = Dartmouth-Northern New England COOP Project; GRIN = Great Lakes Research Into Practice Network; HPRN = High Plains Research Network; KAN = Kentucky Ambulatory Network; MAFPRN = Minnesota Academy of Family Physicians Research Network; MNCCRN = Midwest Nursing Centers Consortium Research Network; NECF = New England Clinicians Forum Practice-Based Research Network; NOPCRN = Northwest Ohio Primary Care Research Network; PBRN = practice-based research network; PDA = personal digital assistant; PitNet = Pediatric PitNet; PPRG = Pediatric Practice Research Group; PSARN = Pennsylvania State Ambulatory Research Network; RAP = Research Association of Practices; RN = registered nurse; VaPSRN = Virginia Practice Support and Research Network.
ACORNWeb-based behavior surveyBrief Web-based counseling messageWeb database of community and behavior change resources
APBRNPDA screening; assess BMIPDA-guided advice to change behaviorPDA-guided goal setting; action plansPersonalized handoutsHealth change facilitatorTelephone follow-up by practice extender
CECHPDA screeningAction plansStage-based counselingE-mail follow-up by health advisor based on action plan
CRNHealth behavior surveyMenu for lifestyle changeAction plansTelephone call 1 wk and 6 mo later
COOPVital sign questions from medical assistants; Web-and paper-based health assessmentBrief adviceWeb site information tailored to patient responsesIndividual counseling, group visits, and referral to community servicesSelf-management supported by automatic feedback to patient, feedback to clinician, and Web-based problem-solving moduleTelephone/e-mail follow-up by RNs; follow-up visits as indicated by responses to vital sign process or feedback from Web health assessment
GRIN*Patient questionnaires; nurse screening; BMI and smoking status as vital signs; 5 A’s chart stickers; healthy weight wall chartBrief advice by physician; brief patient training by clinicians; exercise prescriptionAction plansStage-tailored and need-specific educational materials, lists of local resourcesReferral to community servicesQuit kits; community servicesTelephone follow-up by nurses or community service
HPRN, CaReNetIntake surveyList of recommended behaviorsGoals documented on prescription padsFeedback logs
KAN“Willingness to change” survey; physician queryPhysician prescription/referralMailed educational materialsScheduled longitudinal telephone counselingFaxed feedback to referring physician
MAFPRNStandardized screening for tobacco use, physical activity, diet, risky drinkingBrief motivational enhancement by health coachPrint or online motivational informationTelephone or Web-based motivational counselingSelf-help guidebook; Web site; community resources and programsTelephone and e-mail follow-up by clinics; follow-up visits
MNCCRNAssess diet, physical activity, and BMIParticipation in wellness club recommended by advanced practice nurseWeekly written goalsWritten lesson plans for didactic sessionsSupport group; nutritionist-led didactic sessions; motivational videosFood diaries; pedometer countsTelephone follow-up by educator; health buddies; community activities (see Table 2)
NECFScreening for tobacco use and risky screeningBrief motivational interviewing by physician, nurse, physician assistant, medical assistant, or health educatorLiteratureFollow-up visit
NOPCRNAssess BMI, nutrition, and physical activityPDA-guided goal recommendationPDA-guided goal settingPedometer; activity logTelephone follow-up by nurse-coordinator; biweekly nurse practice visits for weight and BP checks, pedometer downloads, and activity log assessment
PitNetAssess BMI; parent perception surveyBrief motivational interviewingHandouts and homeworkHealth educator group sessionsSelf-monitoring booksTelephone follow-up
PPRGWall chart; nutrition assessmentBrief advice based on nutritional status and menu for lifestyle changeAge- and nutritional status–specific handouts on health behaviors
PSARNAssess BMIEducational bulletin board; educational materialsHealth change facilitator; decision balance exercise; other motivational techniquesSelf-help guidebookHealth change facilitator follow-up in person, by telephone, by e-mail
RAPPrescriptionWeb database of community and behavior change resources
VaPSRNSmoking, BMI, vital signsPDA tool to guide counselingPatient resources suggested by PDA software