What can we generalize from research on patient education and clinical health promotion to physician counseling on diet?

OBJECTIVE

This paper explores the status of knowledge development from clinical trials and other studies of patient education and clinical health promotion.

DESIGN

It asks what this cumulative literature has to offer dietary counseling of patients by family doctors. A series of meta-analyses of drug education and preventive health education research in clinical settings provide a starting framework for guidelines on dietary counseling.

CONCLUSIONS

Smoking cessation studies, in particular, have mounted in quantity and quality to the greatest extent and offer the clearest statement on what can be achieved, under what conditions, and with what support beyond the physician's counseling session or sessions. The Precede-Proceed Model offers a further guide to assuring the comprehensiveness of approaches to dietary change-enabling and reinforcing the change, not just predisposing it through admonitions and altering of knowledge, attitudes and beliefs. The specific evidence supporting the application of a patient counseling algorithm based on the Precede-Proceed model is reviewed here.