Effect of Training and a Structured Office Practice on Physician-delivered Nutrition Counseling: The Worcester-Area Trial for Counseling in Hyperlipidemia (WATCH)

Electronic Tools to Assist with Identification and Counseling for Overweight Patients: a Randomized Controlled Trial

“…Only intervention physicians received brief education regarding weight-related counseling focused on electronic tool usage; however, prior studies have demonstrated that brief educational sessions in isolation from systemic supports have minimal impact on physician counseling patterns. [29][30][31] Attitudes of intervention physicians who did not use the tools are not known since these individuals did not complete the survey. We did not review all available charts due to time and resource limitations; our sample size was adequately powered to detect a significant difference between groups.…”

Alcohol counseling

“…10 Studies in provider-delivered lifestyle interventions also indicate that training is not enough to ensure that counseling will occur. 18,19 Ockene and colleagues have demonstrated that providers working in high-pressure settings with multiple demands on their time will increase their preventive counseling interventions when they have the needed skills and have a facilitative office support system. 18 The support system prompts providers and helps them implement a brief counseling intervention, which otherwise would be overlooked although it is acknowledged to be important.…”

“…18,19 Ockene and colleagues have demonstrated that providers working in high-pressure settings with multiple demands on their time will increase their preventive counseling interventions when they have the needed skills and have a facilitative office support system. 18 The support system prompts providers and helps them implement a brief counseling intervention, which otherwise would be overlooked although it is acknowledged to be important. Solberg and colleagues also reported on the need for a systems-oriented approach to deliver preventive services in a busy practice setting.…”

“…18,24 Trained research assistants administered PEIs to a random sampling of the study population in both special intervention and usual care conditions. These were done in person immediately after completion of the provider visit or by telephone interview within 24 hours if there were patient or interviewer time limitations after the office visit.…”

“…These include lack of training, lack of confidence in alcohol intervention skills, discouragement based on past negative experiences treating alcohol problems, concern about limited time and practice resources, 12,[14][15][16][17] and lack of a structured office system to facilitate providers' intervention. 18,19 To help primary care providers develop alcoholintervention counseling skills, we adapted a smoking intervention training program that we have found to be efficacious to address alcohol. 20 To facilitate use of the alcohol intervention skills, we developed an office support system.…”