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Abstract：
Background Non-communicable chronic diseases (NCCDs), such as cardiovascular disease, diabetes, and cancer, are the leading cause of death and disability and the leading driver of healthcare costs in the U.S. It is estimated that 80% of chronic diseases and premature deaths are attributable to modifiable lifestyle factors related to smoking and alcohol intake, poor eating patterns, and physical inactivity. Inadequate sleep also plays a significant role. Among other directives, primary care providers (PCPs) have the opportunity to contribute to preventing and treating NCCD in their patients. Comprehensive, evidence-based behavioral counseling interventions are recommended to PCPs as a first-line approach to improving outcomes. However, presumably due to a lack of PCP time, training or resources, most patients report not receiving such services. Currently, the extent to which PCPs in Alabama offer or refer patients to health behavior change (HBC) services is unknown. Objectives This study aims to assess the following: (1) Alabama PCPs\' current approaches in facilitating patient HBC in the domains of eating patterns, physical activity, sleep, and stress and (2) the likelihood of the Alabama PCPs referring patients to virtual HBC programs, once developed by an osteopathic medical school in the state. Methods Data were collected from clinic personnel who were knowledgeable regarding the clinic\'s approach to facilitating patient HBC via scripted telephone interviews and online surveys sent via email. The clinic list utilized for the study was derived from a list of VCOM-Auburn clinical preceptors. Primary care and specialty clinics were included. Data were analyzed descriptively to determine the number of clinics that (1) provide, recommend, or refer programs, services, or resources to patients to facilitate HBC related to eating patterns, physical activity, sleep, and stress management and (2) are likely to refer patients to free virtual HBC programs, once developed by an osteopathic medical school in the state. Results Of the 198 clinics that were contacted, 75 were excluded, 46 were \"no response,\" 53 agreed to participate, and 50 completed the survey. Of the 50 clinics that completed the survey, 33 indicated offering resources or referrals for diet, 29 stated they offered resources or referral services for physical activity, 33 indicated offering resources or referrals for sleep, and 28 indicated offering or recommending resources for stress management to patients. Most of the clinics (29/50) felt that their patients would benefit most from a program that facilitates improvement in eating patterns, and 41/50 clinics said that they are either \"somewhat\" or \"extremely\" likely to refer patients to a free VCOM-Auburn HBC program, once available. Conclusions Findings indicate that a significant percentage of PCP clinics are not offering HBC resources to patients and that most PCP clinics would consider referring patients to free VCOM-Auburn HBC programs, once available. Phone data were significantly different from email data. The primary limitations were a low response rate and potential response bias.
摘要：
背景非传染性慢性病(NCCDs)，比如心血管疾病，糖尿病,和癌症，是美国死亡和残疾的主要原因，也是医疗保健成本的主要驱动因素据估计，80％的慢性疾病和过早死亡可归因于与吸烟和饮酒有关的可改变的生活方式因素。糟糕的饮食模式，缺乏体力活动。睡眠不足也起着重要作用。在其他指令中，初级保健提供者(PCP)有机会帮助其患者预防和治疗NCCD.全面,建议PCP采用循证行为咨询干预措施作为改善结局的一线方法.然而,可能是由于缺乏PCP时间,培训或资源，大多数患者报告没有接受此类服务。目前,阿拉巴马州的PCP为患者提供或转介健康行为改变(HBC)服务的程度尚不清楚.目的本研究旨在评估以下内容：（1）阿拉巴马州PCPs目前在饮食模式领域促进患者HBC的方法，身体活动,睡眠,和压力以及（2）阿拉巴马州PCP将患者转介给虚拟HBC计划的可能性，曾经由该州的整骨医学院开发。方法通过脚本式电话访谈和通过电子邮件发送的在线调查，从了解临床方法为患者HBC提供便利的临床人员那里收集数据。用于研究的临床列表来自VCOM-Auburn临床受体的列表。包括初级保健和专科诊所。对数据进行描述性分析，以确定(1)提供的诊所数量，推荐,或引用程序，服务,或向患者提供资源，以促进与饮食模式相关的HBC，身体活动,睡眠,和压力管理，以及(2)可能会将患者推荐到免费的虚拟HBC计划，曾经由该州的整骨医学院开发。结果在联系的198个诊所中，75人被排除在外，46人没有回应，“53同意参加，50人完成了调查。在完成调查的50个诊所中，33表示提供饮食资源或推荐，29人表示，他们为体育活动提供资源或转介服务，33表示提供睡眠资源或推荐，28人表示向患者提供或推荐压力管理资源。大多数诊所（29/50）认为他们的患者将从促进饮食模式改善的计划中受益最大，41/50的诊所表示，他们要么“有点”要么“非常”可能会将患者转介给免费的VCOM-AuburnHBC计划，一旦可用。结论研究结果表明，相当比例的PCP诊所没有向患者提供HBC资源，大多数PCP诊所会考虑将患者转介给免费的VCOM-AuburnHBC计划，一旦可用。电话数据与电子邮件数据明显不同。主要限制是低反应率和潜在反应偏差。
