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Cited by 16Patient-Provider Communication in HealthcareHealth Promotion and Cardiovascular PreventionBehavioral Health and Interventions

Communication about behavioral health risks: A study of videotaped encounters in 2 internal medicine practices

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Makoul, Gregory, Dhurandhar, Anjali, Goel, Mita Sanghavi, Scholtens, Denise, Rubin, Alan S.·2006·Journal of General Internal Medicine
DOI 10.1111/j.1525-1497.2006.00467.xPMC PMC1924697
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Abstract

Background As behavioral health risks account for the major causes of preventable morbidity and mortality in the United States, national guidelines recommend that physicians routinely screen patients for risk factors, and counsel as appropriate.Objectives To assess the scope of health risk screening and characterize the communication content of counseling for health behavior change in 2 general internal medicine practices.Design and participants We studied videotapes of 125 new patient visits to General Internists affiliated with academic medical centers in Chicago, IL (70%) and Burlington, VT (30%). All videotapes were content analyzed to examine (1) the incidence and outcome of screening for diet, exercise, tobacco, alcohol, drugs, sex, seatbelt use, helmet use, firearms, smoke detectors, and sun exposure; (2) the content of counseling for at-risk behaviors, with a focus on 11 counseling tasks associated with health behavior change.Results Patient age in these 125 initial visits ranged from 22 to 85 years. Within the 91 visits that included at least 1 screening attempt, there were a total of 361 distinct screening discussions (mean=3.9, SD=2.2, range=1 to 9). Seventy-four (20.5%) of the 361 screening discussions revealed an at-risk behavior. On average, 2.4 of the 11 counseling tasks were accomplished for each of the 74 behavioral health risks (SD=2.2, range 0 to 9); only education about the problem (56.8%) and general advice about the solution (62.2%) were evident in more than half of the counseling attempts.Conclusions This observational study reveals that communication tasks associated with successful counseling were relatively infrequent occurrences during initial visits in 2 primary care practices.

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  • The old folklore that behavior cannot be changed has been dispelled by numerous randomized controlled trials of effective behavioral interventions.

    “The old folklore that “behavior can’t be changed” has been dispelled by numerous randomized controlled trials of effective behavioral interventions.13–23”

    From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [13]

  • The 5 A's is a comprehensive, unified, validated treatment algorithm to facilitate health behavior change counseling efficiently within the constraints of the medical visit.

    “The 5 A’s is a comprehensive, unified, validated treatment algorithm to facilitate health behavior change counseling efficiently within the constraints of the medical visit.13,18,19,22”

    From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [13]

  • 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 [13]

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Authors
Makoul, G., Dhurandhar, A., Goel, M. S., Scholtens, D., & Rubin, A. S.
Affiliations
  • Northwestern University (US)
  • University of Vermont (US)
Corresponding author
Makoul, Gregory
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2006-07
Volume
21
Issue
7
Pages
698-703
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1111/j.1525-1497.2006.00467.x
PMC
PMC1924697
OpenAlex
W2041538246
Cited by
16
References
60
Citations by year
2026: 1 · 2022: 1 · 2021: 1 · 2019: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 2
FWCI
3.22
Type
journal article
Language
en
Open access
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
health behavior counseling, primary care, physician-patient communication, health behavior change, tobacco use, alcohol consumption, diet and exercise, substance use, seat belt use, firearm safety, sun exposure, sexual behavior, new patient visits
MeSH terms
Communication, Counseling, Health Promotion, Humans, Internal Medicine, Physician-Patient Relations, Risk-Taking, United States, Videotape Recording

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