Abstract
Population-wide health behavior change represents our single greatest hope for improving the health of the nation, reducing the nation’s untenable financial burden, and reducing growing disparities in disease and health status. It will require linking evidence-based individual-level clinical interventions with evidence-based community/public health interventions. (Although we focus on the United States and its efforts addressing health-care reform, the principles noted could be applied to other countries that are addressing prevention in health care.) In this chapter we briefly outline the growth of behavioral medicine from its origins in the mid-1980s – as a multi-disciplinary field focused on identifying the behavioral factors contributing to the prevention, treatment, and management of disease and developing individually focused clinical interventions to address them – to its current broader focus on combined clinical and public health strategies to influence health behaviors population-wide. We use case studies from evidence-based reviews in the field and our experiences with the United States Preventive Services Task Force and the United States Community Prevention Services Task force to briefly illustrate progress in each of these spheres – clinical and community – and to provide strategies to facilitate linkages. The recommendations of both task forces have relied substantially on behavioral medicine research and are regularly used by public health departments, state, local and federal government agencies, health plans, employers, and community-based organizations to guide and support decisions about selecting and funding interventions and related research. We close this chapter with recommendations for future research and practice.
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Agency for Healthcare Research and Quality. (2005). U.S. Preventive Services Task Force. Retrieved June 2, 2005, from http://www.ahrq.gov/clinic/uspstfix.htm
Agency for Healthcare Research and Quality. (2008). U.S. Preventive Services Task Force Grade Definitions. [Electronic Version] from http://www.ahrq.gov/clinic/uspstf/grades.htm.
Agency for Healthcare Research and Quality. (2009). Guide to Clinical Preventive Services. Retrieved September 28, 2009, from http://www.preventiveservices.ahrq.gov
Agency for Healthcare Research and Quality, Association for State and Territorial Health Officers, and Association, A. M. (2008). Summit on Linking Clinical Practice and the Community for Health Promotion (Meeting). Baltimore, MD.
Amundson, G., Gentilli, S., and Wehrle, D. (2005). Health Partners 2005 Clinical Indicators Report. 13. Retrieved October 6, 2009, from http://www.healthpartners.com/files/28455.pdf
An, L. C., Bluhm, J. H., Foldes, S. S., Alesci, N. L., Klatt, C. M. et al (2008). A randomized trial of a pay-for-performance program targeting clinician referral to a state tobacco quitline. Arch Intern Med, 168, 1993–1999.
Bandura, A. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall.
Bentz, C. J. (2000). Implementing tobacco tracking codes in an individual practice association or a network model health maintenance organisation. Tob Control, 9 Suppl 1, I42-I45.
Biener, L., Harris, J., and Hamilton, W. (2000). Impact of the Massachusetts tobacco control programme: population based trend analysis. Brit Med J, 321, 351–354.
Brownson, R. C., Royer, C., Ewing, R., and McBride, T. D. (2006). Researchers and policymakers: travelers in parallel universes. Am J Prev Med, 30, 164–172.
Centers for Disease Control and Prevention. (2009). The Community Guide: Guide to Community Preventive Services. Retrieved September 28, 2009, from http://www.thecommunityguide.org/index.html
Centers for Disease Control and Prevention. (2004). Telephone Quitlines: A Resource for Development, Implementation and Evaluation. Atlanta: U.S. Department of Health and Human Services, National Center for Chronic Disease and Health Promotion, Office of Smoking and Health.
Centers for Disease Control and Prevention. (2007). Decline in Smoking Prevalence – New York City, 2002–2006. MMWR, 56, 604–608.
Cifuentes, M., Fernald, D. H., Green, L. A., Niebauer, L. J., Crabtree, B. F. et al (2005). Prescription for health: changing primary care practice to foster healthy behaviors. Ann Fam Med, 3 Suppl 2, S4–S11.
Coalition for Evidence-Based Policy. (2009). What Works and What Doesn’t Work in Social Policy? Findings From Well-Designed Randomized Controlled Trials. Retrieved September 28, 2009, from http://www.evidencebasedprograms.org/static/
Coffield, A. B., Maciosek, M. V., McGinnis, J. M., Harris, J. R., Caldwell, M. B. et al (2001). Priorities among recommended clinical preventive services. Am J Prev Med, 21, 1–9.
Crabtree, B. F., Miller, W. L., Aita, V. A., Flocke, S. A., and Stange, K. C. (1998). Primary care practice organization and preventive services delivery: a qualitative analysis. J Fam Pract, 46, 403–409.
Etz, R. S., Cohen, D. J., Woolf, S. H., Holtrop, J. S., Donahue, K. E. et al (2008). Bridging primary care practices and communities to promote healthy behaviors. Am J Prev Med, 35, S390–S397.
Fielding, J. E., and Teutsch, S. M. (2009). Integrating clinical care and community health: delivering health. JAMA, 302, 317–319.
Fiore, M., Bailey, W., Cohen, S., Dorfman, S., Goldstein, M., Gritz, E. et al (2000). Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services, Public Health Services.
Fiore, M. C., Croyle, R. T., Curry, S. J., Cutler, C. M., Davis, R. M. et al (2004). Preventing 3 million premature deaths, helping 5 million smokers quit: a national action plan for tobacco cessation. Am J Public Health, 94, 205–211.
Glasgow, R., Orleans, C., Wagner, E., Curry, S., and Solberg, L. (2001). Does the chronic care model serve also as a template for improving prevention? Milbank Quart, 79, 579–612.
Glasgow, R. E., Klesges, L. M., Dzewaltowski, D. A., Estabrooks, P. A., and Vogt, T. M. (2006). Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. Health Educ Res, 21, 688–694.
Glasgow, R. E., Orleans, C. T., and Wagner, E. H. (2001). Does the chronic care model serve also as a template for improving prevention? Milbank Q, 79, 579–612, iv–v.
Goldstein, M. G., Whitlock, E. P., and DePue, J. (2004). Multiple behavioral risk factor interventions in primary care. Summary of research evidence. Am J Prev Med, 27 Suppl, 61–79.
Gordon, L., Graves, N., Hawkes, A., and Eakin, E. (2007). A review of the cost-effectiveness of face-to-face behavioural interventions for smoking, physical activity, diet and alcohol. Chronic Illn, 3, 101–129.
Greco, P. J., and Eisenberg, J. M. (1993). Changing physicians’ practices. N Engl J Med, 329, 1271–1273.
Hartocollis, A. (2009, September 14). Couch potatoes are next challenge for health chief. New York Times, p. 15.
Holtrop, J. S., Dosh, S. A., Torres, T., and Thum, Y. M. (2008). The community health educator referral liaison (CHERL): a primary care practice role for promoting healthy behaviors. Am J Prev Med, 35 Suppl, S365–S372.
Institute of Medicine (2009). Initial National Priorities for Comparative Effectiveness Research. Washington, DC.
Institute of Medicine, Committee on Immunization Finance Policies and Practices, and Division of Health Care Services and Division of Health Promotion and Disease. (2000). Calling the Shots: Immunization Finance Policies and Practices. Washington, DC: National Academy Press.
Institute of Medicine, and Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press.
Institute of Medicine, Hamburg, D. A., Elliot, G. R., and Parron, D. L. (1982). Health and Behavior: Frontiers of Research in the Biobehavioral Sciences. Washington, DC: National Academy Press.
Klesges, R. C., Klesges, L. M., Vander Weg, M. W., DeBon, M., Poston, W. S. et al (2007). Characteristics of Air Force personnel who choose pharmacological aids for smoking cessation following an involuntary tobacco ban and tobacco control program. Health Psychol, 26, 588–597.
Koh, H. K., Judge, C. M., Robbins, H., Celebucki, C. C., Walker, D. K., and Connolly, G. N. (2005). The first decade of the Massachusetts Tobacco Control Program. Public Health Rep, 120, 482–495.
Lichtenstein, E., and Glasgow, R. (1992). Smoking cessation: what have we learned over the past decade? J Consult Clin Psych, 60, 518–527.
McGinnis, J. M., and Foege, W. H. (1993). Actual causes of death in the United States. JAMA, 270, 2207–2212.
Miller, N., Frieden, T. R., Liu, S. Y., Matte, T. D., Mostashari, F. et al (2005). Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation. Lancet, 365, 1849–1854.
Mokdad, A. H., Marks, J. S., Stroup, D. F., and Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. JAMA, 291, 1238–1245.
North American Quitline Consortium. (2006). Retrieved September 28, 2009, from http://www.naquitline.org/
Ockene, J. K., Edgerton, E. A., Teutsch, S. M., Marion, L. N., Miller, T. et al (2007). Integrating evidence-based clinical and community strategies to improve health. Am J Prev Med, 32, 244–252.
Oldridge, N., Furlong, W., Perkins, A., Feeny, D., and Torrance, G. W. (2008). Community or patient preferences for cost-effectiveness of cardiac rehabilitation: does it matter? Eur J Cardiovasc Prev Rehabil, 15, 608–615.
Orleans, C. T., and Cassidy, E. F. (2008). Health-Related Behavior. In A. P. Kovas & J. P. Knicknan (Eds.), Health Care Delivery in the United States, 9th Ed (pp. 267–297). New York, NY: Springer Publishing.
Orleans, C. T., Kraft, M. K., Marx, J. F., and McGinnis, J. M. (2003). Why are some neighborhoods active and others not? Charting a new course for research on the policy and environmental determinants of physical activity. Ann Behav Med, 25, 77–79.
Orleans, C. T., Woolf, S. H., Rothemich, S. F., Marks, J. S., and Isham, G. J. (2006). The top priority: building a better system for tobacco-cessation counseling. Am J Prev Med, 31, 103–106.
Orszag, P. R. (2009). Beyond economics 101: insights into healthcare reform from the Congressional Budget Office. Healthc Financ Manage, 63, 70–75.
Partnership for Prevention. (2008). Smoking Cessation Advice and Help To Quit. Retrieved September 28, 2009, from http://www.prevent.org/content/view/48/103/
Robbins, H., Krakow, M., and Warner, D. (2002). Adult smoking intervention programmes in Massachusetts: a comprehensive approach with promising results. Tob Control, 11 Suppl 2, ii4–ii7.
Schroeder, S. A. (2005). What to do with a patient who smokes. JAMA, 294, 482–487.
Smedley, B. D., and Syme, S. L. (2001). Promoting health: intervention strategies from social and behavioral research. Am J Health Promot, 15, 149–166.
Solomon, L. S., Standish, M. B., and Orleans, C. T. (2009). Creating physical activity-promoting community environments: time for a breakthrough. Prev Med, 36(4), 351–357.
Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. Am J Health Promot, 10, 282–298.
Swartz, S., Cowan, T., Klayman, J., Welton, M., and Leonard, B. (2005). Use and effectiveness of tobacco telephone counseling and nicotine therapy in Maine. Am J Prev Med, 29, 288–294.
Teutsch, S., and Briss, P. (2005). The Guide to Community Preventive Services: what works to promote health. Spanning the boundary between clinics and communities to address overweight and obesity in children. In S. Zaza, P. Briss, & K. Harris (Eds.), Pediatrics, Vol. 116 (pp. 240–241). New York, NY: Oxford University Press.
Wagner, E. H., Austin, B. T., and Von Korff, M. (1996). Organizing care for patients with chronic illness. Milbank Q, 74, 511–544.
Warner, D., Meneghetti, A., Pbert, L., Van Ness, J., DiPadova, P. et al (2002). QuitWorks. A Department of Public Health collaboration with Eight Health Plans in Massachusetts Linking 12,000 Providers and Their Patients Who Smoke to Proactive Telephone Counseling. Paper presented at the Proceedings of the 2002 National Conference on Tobacco or Health. p. 78 (Abstract #CESS–147), San Francisco, CA.
Whitlock, E. P., Orleans, C. T., Pender, N., and Allan, J. (2002). Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med, 22, 267–284.
Whitlock, E. P., Polen, M. R., Green, C. A., Orleans, T., and Klein, J. (2004). Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med, 140, 557–568.
Woolf, S. H., Glasgow, R. E., Krist, A., Bartz, C., Flocke, S. A. et al (2005). Putting it together: finding success in behavior change through integration of services. Ann Fam Med, 3 Suppl 2, S20–S27.
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Ockene, J.K., Orleans, C.T. (2010). Behavioral Medicine, Prevention, and Health Reform: Linking Evidence-Based Clinical and Public Health Strategies for Population Health Behavior Change. In: Steptoe, A. (eds) Handbook of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09488-5_65
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