Frequency and Prioritization of Patient Health Risks from a Structured Health Risk Assessment
Open accessAbstract
PURPOSE: To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. METHODS: Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. RESULTS: On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. CONCLUSIONS: Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change.
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Patient readiness to change is often low in primary care patients.
“Research suggests patient readiness to change is often low in primary care patients (Phillips et al., 2014), which may negatively impact treatment buy-in.”
From Barriers to and Facilitators of Using Evidence-Based, Cognitive–Behavioral Anxiety Interventions in Integrated Primary Care Practice (2023) · cites this paper as Phillips et al., 2014
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References 45 · Cited by 26
Research works printed but not linked: 19
- Fisher EB, Fitzgibbon ML, Glasgow RE, et al. Behavior matters. Am J Prev Med. 2011;40(5):e15-e30.
- Prochaska JJ, Prochaska JM, Prochaska JO. Building a science for multiple-risk behavior change. In: Riekert KA, Ockene JK, Pbert L, eds. The Handbook of Health Behavior Change. 4th ed. New York, NY: Springer; 2014:245-72.
- Glasgow RE, Kaplan RM, Ockene JK, Fisher EB, Emmons KM. Patient-reported measures of psychosocial issues and health behav- ior should be added to electronic health records. Health Aff (Mill- wood). 2012;31(3):497-504.
- Estabrooks PA, Boyle M, Emmons KM, et al. Harmonized patient- reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors. J Am Med Inform Assoc. 2012;19(4):575-582.
- Stange KC, Zyzanski SJ, Jaén CR, et al. Illuminating the 'black box': a description of 4,454 patient visits to 138 family physicians. J Fam Pract. 1998;46(5):377-389.
- Krist AH, Glenn BA, Glasgow RE, et al; MOHR Study Group. Design- ing a valid randomized pragmatic primary care implementation trial: the My Own Health Report (MOHR) project. Implement Sci. 2013;8(73):1-13.
- Glasgow RE. What does it mean to be pragmatic? Pragmatic meth- ods, measures, and models to facilitate research translation. Health Educ Behav. 2013;40(3):257-265.
- Krist AH, Phillips S, Sabo R, et al. Adoption, reach, implementation, and maintenance of a behavioral and mental health assessment in primary care. Ann Fam Med. 2014;12(6):525-533.
- Skinner HA. The drug abuse screening test. Addict Behav. 1982;7(4): 363-371.
- Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097.
- Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998;158(16): 1789-1795.
- Park S, Pan L, Sherry B, Blanck HM. Consumption of sugar- sweetened beverages among US adults in 6 states: Behavioral Risk Factor Surveillance System, 2011. Prev Chronic Dis. 2014;11:E65.
- Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Preva- lence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-627.
- Stange KC, Woolf SH, Gjeltema K. One minute for prevention: the power of leveraging to fulfill the promise of health behavior coun- seling. Am J Prev Med. 2002;22(4):320-323.
- Kessler R, Stafford D, Messier R. The problem of integrating behav- ioral health in the medical home and the questions it leads to. J Clin Psychol Med Settings. 2009;16(1):4-12.
- Miller BF, Mendenhall TJ, Malik AD. Integrated primary care: an inclusive three-world view through process metrics and empirical discrimination. J Clin Psychol Med Settings. 2009;16(1):21-30.
- Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058.
- Brown DW, Balluz LS, Heath GW, et al. Associations between rec- ommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med. 2003;37(5):520-528.
- Lorig KR, Holman H. Self-management education: history, defini- tion, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7.
- Authors
- Phillips, S. M., Glasgow, R. E., Bello, G., Ory, M. G., Glenn, B. A., Sheinfeld-Gorin, S. N., Sabo, R. T., Heurtin-Roberts, S., Johnson, S. B., Krist, A. H., & for the MOHR Study Group
- Affiliations
- Northwestern University (US)
- ORCID
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2014-11-01
- Volume
- 12
- Issue
- 6
- Pages
- 505-513
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC4226771
- OpenAlex
- W2198221488
- Cited by
- 26
- References
- 45
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 3
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance
- Agency for Healthcare Research and Quality
- U.S. Public Health Service (ULTR00058)
- National Cancer Institute
- National Center for Advancing Translational Sciences (ULTR00058)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- health risk assessment, behavioral risk factors, psychosocial risk factors, patient priorities, primary care, obesity, overweight, depression, anxiety, fruit and vegetable intake, physical activity, sleep, body mass index, health status
- MeSH terms
- Adult, Aged, Alcohol Drinking, Anxiety, Communication, Depression, Diet, Female, Health Status, Humans, Male, Middle Aged, Motor Activity, Patient Acceptance of Health Care, Physician-Patient Relations, Primary Health Care, Risk Factors, Sleep, Smoking, Stress, Psychological, Health Behavior, Body Mass Index, Risk Assessment, Substance-Related Disorders
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