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Effectively encouraging patients to change their health behavior is a critical skill for primary care physicians. Modifiable health behaviors contribute to an estimated 40 percent of deaths in the United States.1 Tobacco use, poor diet, physical inactivity, poor sleep, poor adherence to medication, and similar behaviors are prevalent and can diminish the quality and length of patients' lives. Research has found an inverse relationship between the risk of all-cause mortality and the number of healthy lifestyle behaviors a patient follows.2
Family physicians regularly encounter patients who engage in unhealthy behaviors; evidence-based interventions may help patients succeed in making lasting changes. This article will describe brief, evidence-based techniques that family physicians can use to help patients make selected health behavior changes. (See “Brief evidence-based interventions for health behavior change.”)
KEY POINTS
• Modifiable health behaviors, such as poor diet or smoking, are significant contributors to poor outcomes.
• Family physicians can use brief, evidence-based techniques to encourage patients to change their unhealthy behaviors.
• Working with patients to develop health goals, eliminate barriers, and track their own behavior can be beneficial.
• Interventions that target specific behaviors, such as prescribing physical activity for patients who don't get enough exercise or providing patient education for better medication adherence, can help patients to improve their health.
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BRIEF EVIDENCE-BASED INTERVENTIONS FOR HEALTH BEHAVIOR CHANGE
Behavior | Technique | Description |
---|---|---|
All | SMART goal setting | Ensure that goals are specific, measurable, attainable, relevant, and timely. |
Problem-solving barriers | Identify possible barriers to change and develop solutions. | |
Self-monitoring | Have patients keep a record of the behavior they are trying to change. | |
Physical inactivity | Physical activity prescription | Collaboratively work with the patient to pick an activity type, amount, and frequency. |
Unhealthy eating | Small changes | Have patients choose small, attainable goals to change their diets, such as reducing the frequency of desserts or soda intake or increasing daily fruit and vegetable consumption. |
Plate Method | Encourage patients to design their plates to include 50 percent fruits and vegetables, 25 percent lean protein, and 25 percent grains or starches. | |
Lack of sleep | Brief behavioral therapy | After patients complete sleep diaries, use sleep restriction (reducing the amount of time in bed) and sleep scheduling (daily bed and wake-up times). |
Medication nonadherence | Provide education |