PURPOSE: The purpose of this analysis and commentary was to explore the rationale for an integrated approach, within and outside the office, to help patients pursue healthy behaviors. METHODS: We examined the role of integration, building on (1) patterns observed in a limited qualitative evaluation of 17 Prescription for Health projects, (2) several national policy initiatives, and (3) selected research literature on behavior change. RESULTS: The interventions evaluated in Prescription for Health not only identified unhealthy behaviors and advised change, but also enabled patients to access information at home, use self-help methods, obtain intensive counseling, and receive follow-up. Few practices can replicate such a model with the limited staff and resources available in their offices. Comprehensive assistance can be offered to patients, however, by integrating what is feasible in the office with additional services available through the community and information media. CONCLUSIONS: Blending diverse clinical and community services into a cohesive system requires an infrastructure that fosters integration. Such a system provides the comprehensive model on which the quality of both health promotion and chronic illness care depend. Integrating clinical and community services is only the first step toward the ideal of a citizen-centered approach, in which diverse sectors within the community-health care among them-work together to help citizens sustain healthy behaviors. The integration required to fulfill this ideal faces logistical challenges but may be the best way for a fragmented health care system to fully serve its patients.
PURPOSE: The purpose of this analysis and commentary was to explore the rationale for an integrated approach, within and outside the office, to help patients pursue healthy behaviors. METHODS: We examined the role of integration, building on (1) patterns observed in a limited qualitative evaluation of 17 Prescription for Health projects, (2) several national policy initiatives, and (3) selected research literature on behavior change. RESULTS: The interventions evaluated in Prescription for Health not only identified unhealthy behaviors and advised change, but also enabled patients to access information at home, use self-help methods, obtain intensive counseling, and receive follow-up. Few practices can replicate such a model with the limited staff and resources available in their offices. Comprehensive assistance can be offered to patients, however, by integrating what is feasible in the office with additional services available through the community and information media. CONCLUSIONS: Blending diverse clinical and community services into a cohesive system requires an infrastructure that fosters integration. Such a system provides the comprehensive model on which the quality of both health promotion and chronic illness care depend. Integrating clinical and community services is only the first step toward the ideal of a citizen-centered approach, in which diverse sectors within the community-health care among them-work together to help citizens sustain healthy behaviors. The integration required to fulfill this ideal faces logistical challenges but may be the best way for a fragmented health care system to fully serve its patients.
Authors: Maribel Cifuentes; Douglas H Fernald; Larry A Green; Linda J Niebauer; Benjamin F Crabtree; Kurt C Stange; Susan B Hassmiller Journal: Ann Fam Med Date: 2005 Jul-Aug Impact factor: 5.166
Authors: James C Martin; Robert F Avant; Marjorie A Bowman; John R Bucholtz; John R Dickinson; Kenneth L Evans; Larry A Green; Douglas E Henley; Warren A Jones; Samuel C Matheny; Janice E Nevin; Sandra L Panther; James C Puffer; Richard G Roberts; Denise V Rodgers; Roger A Sherwood; Kurt C Stange; Cynthia W Weber Journal: Ann Fam Med Date: 2004 Mar-Apr Impact factor: 5.166
Authors: Deborah S Porterfield; Laurie W Hinnant; Heather Kane; Joseph Horne; Kelly McAleer; Amy Roussel Journal: Am J Public Health Date: 2012-06 Impact factor: 9.308
Authors: Maribel Cifuentes; Douglas H Fernald; Larry A Green; Linda J Niebauer; Benjamin F Crabtree; Kurt C Stange; Susan B Hassmiller Journal: Ann Fam Med Date: 2005 Jul-Aug Impact factor: 5.166
Authors: Alex H Krist; Douglas Shenson; Steven H Woolf; Cathy Bradley; Winston R Liaw; Stephen F Rothemich; Amy Slonim; William Benson; Lynda A Anderson Journal: Am J Prev Med Date: 2013-10 Impact factor: 5.043
Authors: Steven H Woolf; Alex H Krist; Robert E Johnson; Diane B Wilson; Stephen F Rothemich; Gregory J Norman; Kelly J Devers Journal: Ann Fam Med Date: 2006 Mar-Apr Impact factor: 5.166
Authors: Deborah J Cohen; Bijal A Balasubramanian; Nicole F Isaacson; Elizabeth C Clark; Rebecca S Etz; Benjamin F Crabtree Journal: Ann Fam Med Date: 2011 Sep-Oct Impact factor: 5.166