Patient Preferences for Addressing Unhealthy Behaviors, Mental Health Challenges, and Social Needs in Primary Care

Guidelines recommend addressing health behaviors, mental health, and social needs in primary care. However, it is unclear how often patients want support to address these risks. As part of a randomized trial comparing enhanced care planning versus usual care, we evaluated what risks patients wanted to address.

All patients with multiple chronic conditions, 1 or more of which was uncontrolled, from 81 clinicians in 30 primary care practices. Using My Own Health Report (MOHR), patients identified and prioritized their health risks to create a care plan.

All patients had at least 1 unhealthy behavior (100%) and most had a mental health risk (66.8%) and a social need (51.3%). Participants more often chose to create care plans addressing unhealthy behaviors (92.5%) rather than mental health (23.2%), or social needs (12.5%). The most frequently created care plans were for exercise (65.1%), weight loss (37.2%), and nutrition (36.2%).

All patients had 1 or more unhealthy behaviors, mental health risks, or social needs, and were more likely to address health behaviors. We need to better understand these patient choices, and change the culture to normalize the integration of mental health and social care into primary care.