Health habit counseling amidst competing demands

Effects of patient health habits and visit characteristics

Bruce A. Chernof, Scott Sherman, Andrew B. Lanto, Martin L. Lee, Elizabeth M. Yano, Lisa V. Rubenstein

    Research output: Contribution to journalArticle

    Abstract

    OBJECTIVE. This study assesses the effects of competing demands, such as poor health habits or new medical problems, on health-habit counseling during a primary care visit. METHODS. We surveyed a consecutive sample of 1,259 patients visiting primary care clinicians at an academic VA medical center. Before the visit, patients reported their:health status, health habits, and sociodemographics; immediately after the visit, patients reported reasons for the visit and whether they had been counseled about specific health habits. We scored visit acuity ranging from visits for unscheduled walk-in care or new medical problems to scheduled visits for check-ups or old problems. We defined counseling "triggers" as clinical indications for counseling about particular health habits (eg, smoking). We developed a logistic model predicting primary care provider counseling during a visit. RESULTS. Over two-thirds of patients (68.9%) received some health habit counseling. Controlling for other independent variables, patients with more triggers were more likely to report being counseled. Counseling rates went up as visit acuity went down; patients with the lowest visit acuity having 67% greater odds of being counseled than patients with the highest visit acuity. CONCLUSIONS. Physicians set priorities for health-habit counseling during a visit based on patients' health habit problems or triggers; whether the visit is scheduled or walk-in; and whether the patient has new or acute problems. Future research about primary care performance of health habit counseling should account for these patient and visit characteristics, and prevention-oriented health care organizations should ensure access to scheduled "check-up" visits.

    Original languageEnglish (US)
    Pages (from-to)738-747
    Number of pages10
    JournalMedical Care
    Volume37
    Issue number8
    DOIs
    StatePublished - Aug 1 1999

    Fingerprint

    Habits
    Counseling
    Health
    Primary Health Care
    Health Priorities
    Health Status
    Logistic Models
    Smoking
    Organizations
    Delivery of Health Care
    Physicians

    Keywords

    • Counseling
    • Doctor-patient communication
    • Health promotion
    • Health surveys
    • Primary care

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

    Cite this

    Chernof, B. A., Sherman, S., Lanto, A. B., Lee, M. L., Yano, E. M., & Rubenstein, L. V. (1999). Health habit counseling amidst competing demands: Effects of patient health habits and visit characteristics. Medical Care, 37(8), 738-747. https://doi.org/10.1097/00005650-199908000-00004

    Health habit counseling amidst competing demands : Effects of patient health habits and visit characteristics. / Chernof, Bruce A.; Sherman, Scott; Lanto, Andrew B.; Lee, Martin L.; Yano, Elizabeth M.; Rubenstein, Lisa V.

    In: Medical Care, Vol. 37, No. 8, 01.08.1999, p. 738-747.

    Research output: Contribution to journalArticle

    Chernof, BA, Sherman, S, Lanto, AB, Lee, ML, Yano, EM & Rubenstein, LV 1999, 'Health habit counseling amidst competing demands: Effects of patient health habits and visit characteristics', Medical Care, vol. 37, no. 8, pp. 738-747. https://doi.org/10.1097/00005650-199908000-00004
    Chernof, Bruce A. ; Sherman, Scott ; Lanto, Andrew B. ; Lee, Martin L. ; Yano, Elizabeth M. ; Rubenstein, Lisa V. / Health habit counseling amidst competing demands : Effects of patient health habits and visit characteristics. In: Medical Care. 1999 ; Vol. 37, No. 8. pp. 738-747.
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