Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118070

Bonnie G. McRee, MPH¹, Jennifer Granger, MPH², Thomas F. Babor, PhD, MPH¹, and Janice A. Vendetti, MPH¹. (1) Department of Community Medicine and Health Care, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6325, 8606795485, mcree@up.uchc.edu, (2) Department of Clinical Affairs, Connecticut Primary Care Association, 90 Brainard Road Suite 101, Hartford, CT 06114

The burden of behavioral risk factors on disease and health care costs has become an urgent public health concern. Increasing scientific knowledge shows that risk factors such as smoking, risky drinking, unhealthy diet and sedentary lifestyle contribute to a considerable amount of mortality, morbidity and disability. Further, these health risk behaviors tend to cluster together, especially in members of underserved populations. Despite the success of numerous screening and brief intervention (SBI) efficacy trials over the past 25 years, the transition from research to practice in primary care settings has been slow. This project examined three different models to implement a combined SBI program for smokers and at-risk drinkers in high volume Federally Qualified Health Centers (FQHC's). Practices in six New England area FQHC's were randomized to one of two SBI implementation models: the Clinician Model, in which a clinician conducted the brief counseling services or the Specialist Model in which a staff medical assistant or nurse conducted the brief counseling services. A seventh clinic tested a Health Educator Carve Out Model in which an external, non-staff member conducted the SBI services. The relative penetration of each model was assessed. The Health Educator model produced much higher overall screening rates (82%) than the Clinician (18%) or Specialist models (25%). However, rates of intervention for patients who screened positive were similar, with about two-thirds of at-risk patients receiving counseling in each model. A model that carves out key SBI elements to dedicated Health Educators may improve the scope of screening in FQHCs.

Learning Objectives:

• Identify the health burden of behavioral risk factors among underserved populations,
• Understand the gap between research and practice for implementing SBI services in primary care settings,
• Become familiar with effective SBI implementation models.

Keywords: Behavioral Research, Primary Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.