Controlled trial of a time-efficient method of health promotion

Integrating health promotion into daily clinical practice is a challenging undertaking. This project was a prospective trial of a brief physician intervention program, performed as part of routine patient care, that addressed six areas of patients' lifestyle risks (nutrition, exercise, alcohol use, smoking, stress, and seat belt use). The components of the program were lifestyle assessment, physician prescription of lifestyle change, and educational materials. Patients visiting a family practice residency model office for any reason were selected to receive all program components, parts of the program, or no program components. Lifestyle behavior changes over the ensuing four-week period were measured for all groups by a structured phone interview. Patients who received one or more components of the program reported significantly more change at follow-up than those who received no program components (P = .001); the greatest change was seen in the group that received all of the program components. Demographic variables that were significantly related to a higher degree of change were female sex, previous contact with the physician, and being married. In this sample age, income, and education were not related to behavior change. Motivation to change--an expressed desire to work on a given lifestyle area--was a stronger predictor of change than any demographic variable.