Encouraging behavior changes by use of client-held health records.

A process was developed to encourage individuals to take more responsibility for their health by using a client-held health record. The motivation for the record, called a Personal Life Health Plan (PLHP), stems from the fact that the majority of ills which afflict an individual can be abated by behavior changes. The PLHP contains most of what is in a medical record but also has sections which deal with health maintenance; a past health history, a family health history, tables of individualized risks of morbidity and mortality, a health maintenance plan, and tables of physiological measurements. The PLHP process helps to make explicit the steps of 1) naming existing and potential health problems; 2) reflecting on their causes; and 3) taking actions to overcome them. Additionally, the record helps maintain continuity of care. Pilot studies made in two settings indicate that a significant percentage of individuals will use a PLHP and that physicians and nurse practitioners can incorporate it into their routine of providing care with minimal expenditures of time. Longer term studies will be required to determine effects on behavior, compliance and health services utilizations.