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Glasgow, R.E., Goldstein, M., Ockene, J., Pronk, J.P. (2004). Translating What We Have Learned into Practice: Principles and Hyptheses for Addressing Multiple Behaviors in Primary Care. Am J Prev Med 27:(25):88-101. Background: The evidence base regarding what works in practice for helping patients to change multiple risk behaviors is less developed than is the more basic literature on behavior change. Still, there is enough consistency of findings to present testable hypotheses for clinicians and administrators to evaluate and to guide practice until more definitive evidence is available. Methods: The behavior change principles known as the 5 As outline a sequence of support activities (assess, advise, agree, assist, arrange) that are effective for helping patients to change various health behaviors. These same principles also apply at the clinic level for designing activities to support behavior change. Results: Successful practices promoting sustainable changes in multiple behaviors are: patient-centered, tailored, proactive, population-based, culturally proficient, multi-level and ongoing. Often a stepped care model can be used to provide increasingly intensive (and costly) interventions for patients who are not successful at earlier intervention levels. Conclusions: Contextual factors are influential in determining success at both the patient and the office practice level. Therefore, greater attention should be paid to creating supportive family, healthcare system, and community resources and policies. We enumerate 15 hypotheses to be tested for improving patient-clinician interactions and for medical office change. Key Words: Behavior change, primary care, counseling, evidence-based
behavioral medicine, patient-centered, dissemination, effectiveness,
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