Prescriptions for Health - Improving Health Behaviors Through Telephone Linked Care

Study Description and Methods

This project examined the effectiveness of an automated telephone-based counseling tool for patients. The tool (Telephone Linked Care or TLC) is designed to assist patients in changing risky health behaviors. The study evaluated the ability of primary care practices to integrate a system of this nature into routine patient care and the ability of the TLC to guide patients in the selection of a behavioral change activity.

Specific Aims and Objectives

Our specific aims were:

  1. Integrate a proven, totally automated computer counseling telephone intervention, Telephone Linked Care-Behavior Change (TLC-BC), into eight primary care practices;
  2. Demonstrate improvement in health behaviors for individuals randomized to use the TLC-BC system compared to individuals who receive only printed self-help health educational materials. In addition, risky drinking will be identified; and
  3. Evaluate the direct costs associated with the use and operation of the TLC-BC system within the primary care setting.

Timeline

This project was conducted from July 1, 2005 to June 30, 2007.

Status

This project is closed. Please see below for Key Findings and Publications.

Contact Information

For additional information about this study, please contact:

Wilson D. Pace, MD
Research Network Director
AAFP National Research Network
1-800-274-2237, x3120
wpace@aafp.org

Presentations

  1. Wilson D. Pace, MD, FAAFP, “Telephone-linked Care Prescription for Health,” Robert Wood Johnson Foundation Innovators’ Meeting. July 14, 2005, Cheyenne Mountain Resort, Colorado Springs, CO.
  2. Wilson D. Pace, MD, Deborah S. Main, PhD, Brian Manning, MPH, CHES, Julie Wright, PhD, Robert Friedman, MD. “Telephone-linked Care Prescription for Health,” Robert Wood Johnson Foundation Innovators’ Meeting. January 6, 2007, Scottsdale Resort & Conference Center, Scottsdale, AZ.
  3. Wilson D. Pace, MD, Deborah S. Main, PhD, Julie Wright, PhD, Miriam Dickinson, PhD, Martey Dodoo, PhD, Brian Manning, MSPH, CHES, Angela Meers, MSPH, “Telephone-linked Care Prescription for Health,” Robert Wood Johnson Foundation Innovator’s Meeting. May 24, 2007, Cheyenne Mountain Resort, Colorado Springs, CO
  4. Wilson D. Pace, MD, Deborah S. Main, PhD, Brian Manning, MPH, Julie Wright, PhD, Robert Friedman, MD, “Prescriptions for Health Focus Group”, AAFP National Research Network Convocation of Practices and Networks. March 4, 2007, Virginia Beach, VA.

Key Findings and Publications

The project demonstrated that linking all four risky behaviors (tobacco use, lack of physical activity, unhealthy diet, and risky alcohol consumption) into one system was overwhelming for many patients and likely required greater individual support around the behavioral change selection process. The four designated health risk appraisal instruments selected by the Prescription for Health program office were too long for combined use – at least over an interactive voice response system. Patients who were able to engage with a behavioral change activity liked the system and were able to make changes. From this study, the AAFP NRN is exploring other interactive technology-based behavior change approaches with America on the Move and the Center for Human Nutrition at the University of Colorado Denver.

Start-Up and Incremental Practice Expenses for Behavior Change Interventions in Primary Care.(8 page PDF) Dodoo MS, Krist AH, Cifuentes M, Green LA. American Journal of Preventive Medicine 2008;35(5S):S423-S430. PMID: 18929990

Redesigning Primary Care Practice to Incorporate Health Behavior Change(3 page PDF). Green LA, Cifuentes M, Glasgow RE, Stange KC. American Journal of Preventive Medicine 2008;35(5S):S347-S349. PMID: 18929980


This project is funded by grants from Robert Wood Johnson Foundation and the Agency for Healthcare Research and Quality (Grant number 53771).