Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

Gilles, Mary E; Strayer, Louise J.; Leischow, Robert; Feng, Chun; Menke, J. Michael; Sechrest, Lee

doi:10.1186/1478-4505-6-13

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…The level of inter-rater agreement was computed and any differences resolved through discussion. The areas of tobacco control and obesity reduction were chosen because these are among the most important in public health and ones where health professional behaviour has consistently been found to fall short of that recommended by evidence-based guidelines [ 24 - 26 ]. In addition, these documents cover a wide spectrum of behaviour change approaches.…”

Section: Methodsmentioning

confidence: 99%

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

2011

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BackgroundImproving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations.MethodsA systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity.ResultsNineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity.ConclusionsInterventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

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Section: Methodsmentioning

confidence: 99%

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

2011

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“…Studies by Gillies et al(71), and others(37, 52) have shown a relationship between quality and use of systems using a related instrument. An interesting set of related findings was reported in a recent paper by Scholle(72), indicating a negative relationship between quality of care using HEDIS quality measures in diabetes and resource use measures of total utilization of inpatient, surgical and procedures by the same patients at the health plan level.…”

Section: Discussionmentioning

confidence: 95%

Are Characteristics of the Medical Home Associated With Diabetes Care Costs?

Flottemesch

Scholle²,

O’Connor³

et al. 2012

Medical Care

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Objective To examine the relationship between primary care medical home clinical practice systems (PCMH clinical practice systems) corresponding to the domains of the Chronic Care Model and diabetes-related healthcare costs incurred by members of a health plan who have diagnosed Type 2 diabetes and received care at one of 27 Minnesota-based medical groups over a 12-month period. Study Design Cross-sectional analysis of patient-level cost data in relation to the presence of PCMH clinical practice systems by Chronic Care Model domain using the Physician Practice Connections Readiness Survey (PPC-RS). Methods Multivariate regressions adjusting for patient demographics, health status and comorbidities estimated the relationship between the presence of PCMH clinical practice systems as measured by the PPC-RS and three outcomes: total diabetes-related healthcare costs, ambulatory care management costs, and potentially avoidable costs (e.g. unscheduled inpatient and emergency care). Results Two domains of PCMH clinical practice systems as measured by the PPC-RS were significantly associated with reductions in potentially avoidable costs. These were Health Care Organization (p=.04) and clinical reminder systems in the Decision Support domain (p=.01). Compared to medical groups with only quality improvement, those with improved Health Care Organization defined as performance measurement and individual provider feedback averaged $245/patient less. Similarly, medical groups with clinical reminders for counseling averaged $338/patient less. Conclusions PCMH clinical practice systems that correspond to some domains of the Chronic Care Model are related to reduced inpatient and emergency care costs. Further research is needed about how these systems impact costs over time.

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Delivering Health Care with Quality: Epidemiological Considerations

Oleske¹

2009

Epidemiology and the Delivery of Health Care Services

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Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

Abstract: Background: This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures.

Cited by 3 publications

References 5 publications

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Are Characteristics of the Medical Home Associated With Diabetes Care Costs?

Delivering Health Care with Quality: Epidemiological Considerations

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