Implementing health behavior change in primary care: Lessons from prescription for health

Deborah J. Cohen, Alfred F. Tallia, Benjamin F. Crabtree, Denise M. Young

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

PURPOSE: Our objective was to identify themes that emerged from the evaluation of 17 interventions funded by the Robert Wood Johnson Foundation's Prescription for Health that aimed to enhance adherence to healthy behaviors in the primary care setting. METHODS: We performed a content analysis of diary data from this 16-month initiative. Other data sources used to complement this analysis include funded grant applications and field notes from interviews with investigative teams and a limited number of site visits. Participants were 17 practice-based research networks (PBRNs) that had projects funded during Round 1 of Prescription for Health. RESULTS: Five themes emerged regarding implementation of health behavior change: (1) health behavior change resources are enthusiastically received by practices and patients, and when given a choice, patients prefer methods of assistance that involve personal contact; (2) practice extenders require extensive training, as well as careful case management and support, in order to function fully and avoid burnout; (3) integrating behavior change tools into the primary care setting requires time, effort, and often specialized expertise; (4) even simple interventions require practice change, and use of a practice change model to guide implementation efforts is crucial; and (5) research philosophy and project management approaches vary across PBRNs and have implications for the potential sustainability of an intervention. CONCLUSIONS: A more versatile, multifaceted solution involving new tools, technologies, and multidisciplinary care teams is needed in order to integrate health behavior change into everyday primary care routines. Even the best interventions require a model to articulate how to integrate an innovation into practices.

Original languageEnglish (US)
Pages (from-to)S12-S19
JournalAnnals of family medicine
Volume3
Issue numberSUPPL.2
DOIs
StatePublished - 2005

Keywords

  • Behavior
  • Health behavior
  • Health care delivery
  • Health promotion/disease prevention
  • Practice of medicine
  • Practice-based research
  • Primary care

ASJC Scopus subject areas

  • Family Practice

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