3141.0: Monday, November 13, 2000 - 2:30 PM

Abstract #4326

Strengthening chronic disease partnerships through changing clinical behavior

Noreen M. Clark, PhD1, Molly Gong, MD1, David Evans, PhD2, and Robert B. Mellins, MD3. (1) Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 S. Observatory Street, Ann Arbor, MI 48109-2029, 734-763-5454, nmclark@umich.edu, (2) Department of Clinical Public Health, Columbia University College of Physicians & Surgeons, 630 West 168th Street, New York, NY 10032, (3) Department of Pediatrics, Columbia University College of Physicians & Surgeons, 630 West 168th Street, New York, NY 10032

Managing a chronic disease effectively requires an ongoing partnership between the clinician (physician, nurse, or other clinical specialist) and the patient and his/her family. Increasingly, health educators face the challenge of designing interventions that can influence clinician behavior so that effective clinician-patient partnerships can be forged. This NHLBI-supported study assessed an interactive seminar for physicians treating children with asthma designed to improve their prescribing patterns, communication skills, and education of patients. A thorough review of the literature uncovered 10 clinician behaviors shown in research to be associated with patient satisfaction, patient behavior, and/or improved health status and these comprised the competencies to be developed in the seminar.

At the time of final follow-up (two years from baseline), significant differences in outcome were apparent between the experimental and control groups: treatment group physicians were more likely than control physicians to use protocols for delivering asthma education (OR 4.9, p=02), write down for patients more often how to adjust medicines when symptoms change (OR 5.7, p=.05), and provide more guidelines for modifying therapy (OR 3.8, p=.06). Parents scored treatment group physicians higher than control physicians on five specific positive communication behaviors. Children seen by treatment group physicians had fewer hospitalizations (p=.03) and those with higher levels of emergency department (ED) use at baseline had fewer subsequent ED visits (p=.03).

Learning Objectives: At the conclusion of this session, the attendees will be able to: 1. Describe 10 behaviors of health professionals associated with positive patient outcomes. 2. Describe findings of an interactive seminar for health professionals on patient behavior and health care use

Keywords: Asthma, Education

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA