Direct observation and patient recall of health behavior advice

Flocke, Susan A.; Stange, Kurt C.

doi:10.1016/j.ypmed.2003.11.004

Cited by 129 publications

(139 citation statements)

References 22 publications

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“…Patients counseled about nutrition and exercise are more likely to recall the advice if the advice is of a relatively long duration or relevant to a current health problem. 50 However, the possibility that advice recall may be biased simply underscores the likelihood that those who cannot remember being advised are no different in effect from those who were not advised at all, in that neither group received adequate counseling to be effective for weight loss. Also, there is no evidence that any such bias has changed over time.…”

Section: Discussionmentioning

confidence: 99%

Trends in professional advice to lose weight among obese adults, 1994 to 2000

et al. 2005

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Context: Obesity is a fast‐growing threat to public health in the U.S., but information on trends in professional advice to lose weight is limited. Objective: We studied whether rising obesity prevalence in the U.S. was accompanied by an increasing trend in professional advice to lose weight among obese adults. Design and Participants: We used the Behavioral Risk Factor Surveillance System, a cross‐sectional prevalence study, from 1994 (n=10,705), 1996 (n=13,800), 1998 (n=18,816), and 2000 (n=26,454) to examine changes in advice reported by obese adults seen for primary care. Measurements: Self‐reported advice from a health care professional to lose weight. Results: From 1994 to 2000, the proportion of obese persons receiving advice to lose weight fell from 44.0% to 40.0%. Among obese persons not graduating from high school, advice declined from 41.4% to 31.8%; and for those with annual household incomes below $25,000, advice dropped from 44.3% to 38.1%. In contrast, the prevalence of advice among obese persons with a college degree or in the highest income group remained relatively stable and high (>45%) over the study period. Conclusions: Disparities in professional advice to lose weight associated with income and educational attainment increased from 1994 to 2000. There is a need for mechanisms that allow health care professionals to devote sufficient attention to weight control and to link with evidence‐based weight loss interventions, especially those that target groups most at risk for obesity.

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Section: Discussionmentioning

confidence: 99%

Trends in professional advice to lose weight among obese adults, 1994 to 2000

et al. 2005

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“…Accountability measures for BI based on patient report would create incentives for health-care systems to identify patients with hazardous drinking so that BI could be provided. Such measures might also motivate providers to have longer alcohol-related discussions, as the duration of medical counseling is a strong predictor of patient recall [13]. Questions about BI would need to be preceded with an agreed-upon validated alcohol screen, such as the consumption questions of the Alcohol Use Disorders Identification Test (AUDIT) used by Nilsen et al [4] to allow comparisons across healthcare systems.…”

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confidence: 99%

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Bradley

Johnson²,

Williams³

2011

Addiction

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“…34 Another study reported rates of patient recall of PCP-delivered health behavior advice ranging from 76 % (for smoking cessation) to 17 % (for STD prevention), with substantial variability due to the reason for the visit and the amount of time spent discussing the targeted behavior. 35 Accuracy of patient reports declines rapidly with increasing time from the event. 36 The close proximity of our interview to the PCP appointment (median = 1 day) limits the influence of recall bias.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

et al. 2016

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BACKGROUND: Brief interventions for unhealthy drinking in primary care settings are efficacious, but underutilized. Efforts to improve rates of brief intervention though provider education and office systems redesign have had limited impact. Our novel brief intervention uses interactive voice response (IVR) to provide information and advice directly to unhealthy drinkers before a physician office visit, with the goals of stimulating in-office dialogue about drinking and decreasing unhealthy drinking. This automated approach is potentially scalable for wide application. OBJECTIVE: We aimed to examine the effect of a pre-visit IVR-delivered brief alcohol intervention (IVR-BI) on patient-provider discussions of alcohol during the visit. DESIGN: This was a parallel group randomized controlled trial with two treatment arms: 1) IVR-BI or 2) usual care (no IVR-BI). PARTICIPANTS: In all, 1,567 patients were recruited from eight university medical center-affiliated internal medicine and family medicine clinics. INTERVENTIONS: IVR-BI is a brief alcohol intervention delivered by automated telephone. It has four components, based on the intervention steps outlined in the National Institute of Alcohol Abuse and Alcoholism guidelines for clinicians: 1) ask about alcohol use, 2) assess for alcohol use disorders, 3) advise patient to cut down or quit drinking, and 4) follow up at subsequent visits. MAIN MEASURES: Outcomes were patient reported: patient-provider discussion of alcohol during the visit; patient initiation of the discussion; and provider's recommendation about the patient's alcohol use. KEY RESULTS: Patients randomized to IVR-BI were more likely to have reported discussing alcohol with their provider (52 % vs. 44 %, p = 0.003), bringing up the topic themselves (20 % vs. 12 %, p < 0.001), and receiving a recommendation (20 % vs. 14 %, p < 0.001). Other predictors of outcome included baseline consumption, education, age, and alcohol use disorder diagnosis. CONCLUSIONS: Providing automated brief interventions to patients prior to a primary care visit promotes discussion about unhealthy drinking and increases specific professional advice regarding changing drinking behavior.

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Direct observation and patient recall of health behavior advice

Cited by 129 publications

References 22 publications

Trends in professional advice to lose weight among obese adults, 1994 to 2000

Trends in professional advice to lose weight among obese adults, 1994 to 2000

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient–Provider Communication in Primary Care

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