PBRN | Description |
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PBRN 1 | Study tested whether 5As intervention using EHR improved unhealthy behaviors in primary care patients, compared with usual care. EHR prompted rooming staff to ask about and record health risk; EHR identified patient risk and, when risk was present, prompted clinicians to consider brief counseling; if clinician chose to counsel patients, the EHR prompted the clinician through a 5As-based brief counseling process that gave clinicians the ability to click to refer patients to 1 of 4 external counseling options: Web-based counseling, telephone counseling, group counseling, usual care. Patients selecting telephone or group counseling were called by resource within 24 hours to set up counseling sessions. Participating practices = 9, within a single health system using the same EHR |
PBRN 2 | Study tested preventing unhealthy diet/activity behaviors by targeting 2-year-old well-child visit with new goal-setting tool and referral to a health educator, as compared with usual care. Patients completed HRA in waiting room before 2-year-old well-child visits using paper-based protocol with assistance from staff, as needed; HRA triggered clinician to provide brief counseling and goal-setting and referral to health educator provided by study; health educator called patients to schedule a counseling visit and then referred to available resources when needed. Participating practices = 6 |
PBRN 3 | Study tested the effect of having a health educator/community liaison available to practices. Practices identified at-risk patients; referred patients to health educator/community liaison, who conducted a HRA, provided counseling and follow-up, and assisted in connecting patients to community resources. Participating practices = 15, located in 3 disparate geographic areas |
PBRN 4 | Study tested use of PDA-based comprehensive health screener as a catalyst to enhance counseling, communication, referrals, and follow-up related to behavior change in adolescents, as compared with usual care. Adolescent patients conducted self-HRA using PDA in waiting room; results reviewed before the examination; clinicians offered brief counseling and provided resource card and referrals as needed. Participating practices = 8 |
PBRN 5 | Study tested impact of performance feedback, training, practice facilitation, and local QI collaboratives on health behavior change efforts in primary care. Study provided monthly performance audits, training for each behavior and for motivational interviewing; study facilitated plan-do-study-act cycles to add screening of behaviors, one by one, cumulatively, as part of vital signs process; patients given printed handouts and referrals as appropriate; regional area practices shared performance data and lessons learned. Participating practices=9 |
PBRN 6 | Study promoted screening, counseling, and community resource use through collaboration with local health department using extension agent model. Patients conducted IT-based self-HRA and readiness to change assessment in the waiting room; the HRA was printed and triggered brief counseling and referral to extension resources and other existing resources by clinician. Participating practices=6 |
PBRN 7 | Study tested MA-led program designed to identify patients at risk for poor health behaviors, who were offered counseling and referral to community resource, as compared with usual care. MAs reviewed recent electronic-based patient HRAs and assessed patient readiness to change, offered brief counseling and referral for ready patients at risk for behaviors covered by written protocol, and alerted clinicians to patients at risk and ready to change but who were outside the MA protocol. Participating practices = 6 |
PBRN 8 | Study tested patient use of provision of Web-based tools to assist patients with health behaviors, as compared with usual care. Letters issued to patients identified by practice mailing list. Letters prompted patients to conduct self-HRA via Web site; patients received feedback, at-risk patients encouraged to participate in Web-based counseling; system could update clinician on patient progress. Participating practices = 6 |
PBRN 9 | Study tested integration of proven interactive telephone voice response system into primary care practices to promote behavior change, as compared with provision of educational materials only. Clinicians or practice staff identified appropriate patients, provided educational materials and brief counseling message, and referred to telephone counseling system. Patients were to call the system; HRA conducted by the system on first call. Patients determined to be at risk for poor health behaviors were encouraged by the telephone system to call in weekly for counseling. Participating practices = 8 |
5As = ask, advise, assess, assist, arrange; EHR = electronic health record; HRA = health risk assessment; IT=information technology; MA=medical assistant; PDA=personal digital assistant; QI=quality improvement.