Interventions Evaluated in Prescription for Health Projects, by Counseling Step
| 4. More Intensive Assistance (Assist) | |||||||
|---|---|---|---|---|---|---|---|
| PBRN | 1. Identify Behaviors and Health Conditions (Assess) | 2. Brief Advice/Training (Advise) | 3. Goal Setting (Agree) | Information | Counseling | Self-Management | 5. 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. | |||||||
| ACORN | Web-based behavior survey | Brief Web-based counseling message | Web database of community and behavior change resources | ||||
| APBRN | PDA screening; assess BMI | PDA-guided advice to change behavior | PDA-guided goal setting; action plans | Personalized handouts | Health change facilitator | Telephone follow-up by practice extender | |
| CECH | PDA screening | Action plans | Stage-based counseling | E-mail follow-up by health advisor based on action plan | |||
| CRN | Health behavior survey | Menu for lifestyle change | Action plans | Telephone call 1 wk and 6 mo later | |||
| COOP | Vital sign questions from medical assistants; Web-and paper-based health assessment | Brief advice | Web site information tailored to patient responses | Individual counseling, group visits, and referral to community services | Self-management supported by automatic feedback to patient, feedback to clinician, and Web-based problem-solving module | Telephone/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 chart | Brief advice by physician; brief patient training by clinicians; exercise prescription | Action plans | Stage-tailored and need-specific educational materials, lists of local resources | Referral to community services | Quit kits; community services | Telephone follow-up by nurses or community service |
| HPRN, CaReNet | Intake survey | List of recommended behaviors | Goals documented on prescription pads | Feedback logs | |||
| KAN | “Willingness to change” survey; physician query | Physician prescription/referral | Mailed educational materials | Scheduled longitudinal telephone counseling | Faxed feedback to referring physician | ||
| MAFPRN | Standardized screening for tobacco use, physical activity, diet, risky drinking | Brief motivational enhancement by health coach | Print or online motivational information | Telephone or Web-based motivational counseling | Self-help guidebook; Web site; community resources and programs | Telephone and e-mail follow-up by clinics; follow-up visits | |
| MNCCRN | Assess diet, physical activity, and BMI | Participation in wellness club recommended by advanced practice nurse | Weekly written goals | Written lesson plans for didactic sessions | Support group; nutritionist-led didactic sessions; motivational videos | Food diaries; pedometer counts | Telephone follow-up by educator; health buddies; community activities (see Table 2) |
| NECF | Screening for tobacco use and risky screening | Brief motivational interviewing by physician, nurse, physician assistant, medical assistant, or health educator | Literature | Follow-up visit | |||
| NOPCRN | Assess BMI, nutrition, and physical activity | PDA-guided goal recommendation | PDA-guided goal setting | Pedometer; activity log | Telephone follow-up by nurse-coordinator; biweekly nurse practice visits for weight and BP checks, pedometer downloads, and activity log assessment | ||
| PitNet | Assess BMI; parent perception survey | Brief motivational interviewing | Handouts and homework | Health educator group sessions | Self-monitoring books | Telephone follow-up | |
| PPRG | Wall chart; nutrition assessment | Brief advice based on nutritional status and menu for lifestyle change | Age- and nutritional status–specific handouts on health behaviors | ||||
| PSARN | Assess BMI | Educational bulletin board; educational materials | Health change facilitator; decision balance exercise; other motivational techniques | Self-help guidebook | Health change facilitator follow-up in person, by telephone, by e-mail | ||
| RAP | Prescription | Web database of community and behavior change resources | |||||
| VaPSRN | Smoking, BMI, vital signs | PDA tool to guide counseling | Patient resources suggested by PDA software | ||||