School of Psychology, University of Newcastle, Callaghan, Australia; Hunter New England Population Health, Wallsend, Australia.
Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
Prev Med. 2019 Jun;123:308-315. doi: 10.1016/j.ypmed.2019.03.046. Epub 2019 Mar 28.
Primary healthcare services are recommended to provide preventive care to address chronic disease risk behaviours. However, all care elements are infrequently provided, and there is a need to understand the impact of partial care provision on behaviour change. This study examined the association between variable levels of preventive care receipt from primary care clinicians on short-term behaviour change for four risk behaviours. A survey was undertaken with 5639 Australian community health service clients (2009-2014). Clients self-reported: engagement in risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, physical inactivity) in the month prior to and four week post their community health service appointment; receipt of preventive care during appointments (assessment, advice, referral/follow-up) for each behaviour. Univariate regression models explored the association between change in risk status and preventive care received. The odds of behaviour change for those receiving all three care elements was significant for all behaviours, compared to no care, ranging from 2.02 (alcohol consumption, 95% CI 1.16-3.49) to 4.17 (inadequate fruit and/or vegetable consumption, 95% CI 2.91-5.96). Receipt of both assessment and advice increased the odds of behaviour change, compared to no care, for all behaviours except smoking, ranging from 2.32 (physical inactivity, 95% CI 1.60-3.35) to 2.83 (alcohol consumption, 95% CI 1.84-4.33). Receipt of 'assessment only' increased the odds of behaviour change, compared to no care, for inadequate fruit and/or vegetable consumption (OR = 2.40, 95% CI 1.60-3.59) and physical inactivity (OR = 2.81, 95% CI 1.89-4.17). Results highlight the importance of primary care clinicians providing best practice preventive care to maximise client behaviour change.
初级保健服务被建议提供预防保健以解决慢性病风险行为。然而，所有的保健元素都很少提供，因此需要了解部分保健提供对行为改变的影响。本研究调查了初级保健临床医生提供的预防保健的不同水平与四种风险行为的短期行为改变之间的关联。对 5639 名澳大利亚社区卫生服务客户（2009-2014 年）进行了调查。客户在社区卫生服务预约前一个月和预约后四周自我报告：参与风险行为（吸烟、有害饮酒、水果和/或蔬菜摄入不足、身体活动不足）；在预约期间（评估、建议、转诊/随访）接受预防保健。单变量回归模型探讨了风险状况变化与预防保健之间的关联。与没有保健相比，接受所有三种保健元素的人在所有行为上的行为改变的几率都显著，范围从 2.02（饮酒，95%CI 1.16-3.49）到 4.17（水果和/或蔬菜摄入不足，95%CI 2.91-5.96）。与没有保健相比，接受评估和建议都会增加所有行为的行为改变几率，除了吸烟，范围从 2.32（身体活动不足，95%CI 1.60-3.35）到 2.83（饮酒，95%CI 1.84-4.33）。与没有保健相比，接受“仅评估”会增加水果和/或蔬菜摄入不足（OR=2.40，95%CI 1.60-3.59）和身体活动不足（OR=2.81，95%CI 1.89-4.17）的行为改变几率。结果强调了初级保健临床医生提供最佳实践预防保健以最大程度地促进客户行为改变的重要性。
