Fernald Douglas H, Froshaug Desireé B, Dickinson L Miriam, Balasubramanian Bijal A, Dodoo Martey S, Holtrop Jodi Summers, Hung Dorothy Y, Glasgow Russell E, Niebauer Linda J, Green Larry A
Department of Family Medicine, School of Medicine, University of Colorado Denver, Aurora, Colorado 80045, USA.
Am J Prev Med. 2008 Nov;35(5 Suppl):S414-22. doi: 10.1016/j.amepre.2008.08.006.
Primary care offices have been characterized as underutilized settings for routinely addressing health behaviors that contribute to premature death and unnecessary suffering. Practical tools are needed to routinely assess multiple health risk behaviors among diverse primary care patients. The performance of a brief set of behavioral measures used in primary care practice is reported here.
Between August 2005 and January 2007, 75 primary care practices assessed four health behaviors, using a 21-item patient self-report questionnaire for adults or a 16-item questionnaire for adolescents. Data were collected via telephone, paper, or electronic means, either with or without assistance. The performance of these measures was evaluated by describing risk-behavior prevalences, combinations of risk behaviors, and missing data.
Of 227 adolescents and 5358 adults, most patients completed all of the survey questions. Two or more unhealthy behaviors were reported by 47.1% of adolescents and 69.2% of adults. Percentages of adults who completed all the survey items varied by health behavior: tobacco use, 98.5%; diet, 98.2%; physical activity, 96.2%; alcohol use, 85.1%. Missing data rates were higher for unassisted patient self-reporting.
A relatively brief set of health behavior measures was usable in a variety of primary care settings with adults and adolescents. The performance of these measures was uneven across behaviors and administration modes, but yielded estimates of unhealthy behaviors consistent overall with what would be expected based on published population estimates. Further work is needed on measures for alcohol use and physical activity to bring practical assessment tools for key health behaviors to routine primary care practice.
基层医疗诊所被认为是未得到充分利用的场所，未能常规处理那些导致过早死亡和不必要痛苦的健康行为。需要实用工具来常规评估不同基层医疗患者的多种健康风险行为。本文报告了在基层医疗实践中使用的一组简短行为测量指标的表现。
2005年8月至2007年1月期间，75家基层医疗诊所使用针对成年人的21项患者自我报告问卷或针对青少年的16项问卷评估了四种健康行为。数据通过电话、纸质或电子方式收集，有无协助均可。通过描述风险行为患病率、风险行为组合和缺失数据来评估这些测量指标的表现。
在227名青少年和5358名成年人中，大多数患者完成了所有调查问题。47.1%的青少年和69.2%的成年人报告了两种或更多不健康行为。完成所有调查项目的成年人百分比因健康行为而异：吸烟，98.5%；饮食，98.2%；身体活动，96.2%；饮酒，85.1%。无协助的患者自我报告的缺失数据率更高。
一组相对简短的健康行为测量指标可用于各种针对成年人和青少年的基层医疗环境。这些测量指标在不同行为和管理模式下的表现参差不齐，但得出的不健康行为估计总体上与基于已发表的人群估计所预期的一致。需要进一步研究饮酒和身体活动的测量指标，以便将关键健康行为的实用评估工具引入常规基层医疗实践。
