Glasgow Russell E, Ory Marcia G, Klesges Lisa M, Cifuentes Maribel, Fernald Douglas H, Green Larry A
Kaiser Permanente, Denver, CO, USA.
Ann Fam Med. 2005 Jan-Feb;3(1):73-81. doi: 10.1370/afm.261.
With increasing evidence for the value of behavior change counseling, there is a need for health behavior measurements that can be implemented in primary care research. This article discusses criteria for and reviews self-report measures to briefly assess cigarette smoking, eating patterns, physical activity, and risky drinking across the life course. It then proposes pragmatic measures for use in practice-based research.
Drawing from literature reviews, previous multisite studies, personal communications with experts in the field, and guidance from an expert panel, we identified self-report behavior change measures and gave priority to items that addressed Healthy People 2010 goals, as well as those that were practical (ie, shorter, and easier to score and use for intervention), were sensitive to change, and produced results that could directly inform primary care intervention.
Separate recommendations are described for measures for adults and for children/adolescents. We recommend a set of 22 items for adults and 16 items for adolescents to track succinctly their status on the 4 health behaviors above. Perfected measures remain elusive: newly developed measures of physical activity and eating patterns are recommended, and in general, the brief measures for adults are currently better validated than are the child measures.
A set of totally satisfactory practical instruments for measuring behavior change in primary care settings does not yet exist. There is sufficient progress to encourage use of and further research on the proposed items. Use of a common set of items across different interventions and projects will help to advance clinical and behavioral research in primary care settings.
随着行为改变咨询价值的证据越来越多,需要在初级保健研究中能够实施的健康行为测量方法。本文讨论了简要评估一生中吸烟、饮食模式、身体活动和危险饮酒的自我报告测量方法的标准并进行综述。然后提出了在基于实践的研究中使用的实用测量方法。
通过文献综述、以往的多中心研究、与该领域专家的个人交流以及专家小组的指导,我们确定了自我报告行为改变测量方法,并优先考虑那些涉及《健康人民2010》目标的项目,以及那些实用的项目(即更短、更容易评分和用于干预),对变化敏感,并能产生可直接为初级保健干预提供信息的结果的项目。
针对成人和儿童/青少年的测量方法分别给出了建议。我们建议为成年人设置一组22个项目,为青少年设置一组16个项目,以简洁地跟踪他们在上述4种健康行为方面的状况。完善的测量方法仍然难以捉摸:推荐新开发的身体活动和饮食模式测量方法,总体而言,目前成人的简短测量方法比儿童测量方法得到了更好的验证。
目前还不存在一套在初级保健环境中测量行为改变的完全令人满意的实用工具。已经取得了足够的进展来鼓励对所提议的项目进行使用和进一步研究。在不同的干预措施和项目中使用一组共同的项目将有助于推动初级保健环境中的临床和行为研究。