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Cited by 1,057Health Promotion and Cardiovascular PreventionClinical practice guidelines implementationBehavioral Health and Interventions

Evaluating primary care behavioral counseling interventions An evidence-based approach

Whitlock, E·2002·American Journal of Preventive Medicine
DOI 10.1016/s0749-3797(02)00415-4
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Abstract

Risky behaviors are a leading cause of preventable morbidity and mortality, yet behavioral counseling interventions to address them are underutilized in healthcare settings. Research on such interventions has grown steadily, but the systematic review of this research is complicated by wide variations in the organization, content, and delivery of behavioral interventions and the lack of a consistent language and framework to describe these differences. The Counseling and Behavioral Interventions Work Group of the United States Preventive Services Task Force (USPSTF) was convened to address adapting existing USPSTF methods to issues and challenges raised by behavioral counseling intervention topical reviews. The systematic review of behavioral counseling interventions seeks to establish whether such interventions addressing individual behaviors improve health outcomes. Few studies directly address this question, so evidence addressing whether changing individual behavior improves health outcomes and whether behavioral counseling interventions in clinical settings help people change those behaviors must be linked. To illustrate this process, we present two separate analytic frameworks derived from screening topic tools that we developed to guide USPSTF behavioral topic reviews. No simple empirically validated model captures the broad range of intervention components across risk behaviors, but the Five A's construct-assess, advise, agree, assist, and arrange-adapted from tobacco cessation interventions in clinical care provides a workable framework to report behavioral counseling intervention review findings. We illustrate the use of this framework with general findings from recent behavioral counseling intervention studies. Readers are referred to the USPSTF (www.ahrq.gov/clinic/prevenix.htm or 1-800-358-9295) for systematic evidence reviews and USPSTF recommendations based on these reviews for specific behaviors.

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Crossref · 10.1016/s0749-3797(02)00415-4

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  • A 5 A's approach has been shown to produce significant changes in a variety of health behaviors, including smoking cessation, dietary change, and physical activity.

    “A 5 A’s approach has been shown to produce significant changes in a variety of health behaviors, including smoking cessation, dietary change, and physical activity.13,26,38–44”

    From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [43]

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Authors
Whitlock, E.
Affiliations
Kaiser Permanente (US)
Corresponding author
Whitlock, E
ORCID
Whitlock, E
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2002-05
Volume
22
Issue
4
Pages
267-284
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/s0749-3797(02)00415-4
OpenAlex
W1491309707
Cited by
1,057
References
126
Citations by year
2026: 30 · 2025: 31 · 2024: 33 · 2023: 29 · 2022: 31 · 2021: 37 · 2020: 90 · 2019: 43 · 2018: 36 · 2017: 52 · 2016: 61 · 2015: 50 · 2014: 59 · 2013: 52 · 2012: 53
FWCI
33.12
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (290-97-0018)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
primary care, USPSTF, risk-taking, tobacco cessation
MeSH terms
Adult, Child, Counseling, Female, Health Promotion, Humans, Male, Preventive Health Services, United States, Health Behavior, Evidence-Based Medicine

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