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开发一种多成分干预措施以启动初级保健中的健康行为改变:启动健康计划

Development of a Multicomponent Intervention to Initiate Health Behavior Change in Primary Care: The Kickstart Health Program.

作者信息

Clark-Sienkiewicz Shannon M, Caño Annmarie, Zeman Lori Lackman, Lumley Mark A, Gothe Neha

机构信息

Department of Psychology, Wayne State University, Detroit, MI, USA.

Beaumont Health, Sterling Heights, MI, USA.

出版信息

J Clin Psychol Med Settings. 2021 Dec;28(4):694-705. doi: 10.1007/s10880-020-09755-z. Epub 2021 Jan 5.

Abstract

There is a growing movement to integrate behavioral health specialists into primary care settings in order to better manage patients' health behaviors. Group interventions in healthcare settings can provide services to multiple individuals simultaneously; however, the participants' experiences taking part in these activities and the logistics of integrating them into clinical settings are largely under-studied. This article describes the development and implementation of a novel group intervention for health behavior change, The Kickstart Health Program, which integrates components of cognitive, behavioral, acceptance, and experiential therapies. Participant feasibility, acceptability, experiences, and treatment course were assessed. Acceptability among a small sample of attendees was high, and initial data on behavior change suggest there were benefits to patients who attended the program. Increases in mindfulness practice and decreases in exercise barriers from baseline to 10-week follow-up were detected as were improvements in overall perceived health and well-being. Participants expressed that the program was acceptable and successful at helping them reach their individual health goals; however, enrollment barriers negatively impacted the feasibility of the program in regard to attendance. Modification to the enrollment process such as embedding referrals into the electronic medical record, encouraging spouse or family co-enrollment, and peer coaching may address these barriers. The Kickstart Health Program has the potential to improve health behaviors and paves the way for unique studies of dissemination and implementation of efficacious behavioral health interventions into real-world healthcare settings.

摘要

将行为健康专家纳入初级保健机构以更好地管理患者健康行为的趋势正在不断发展。医疗机构中的团体干预可以同时为多个个体提供服务;然而,参与者参与这些活动的体验以及将其融入临床环境的后勤工作在很大程度上仍未得到充分研究。本文介绍了一种用于健康行为改变的新型团体干预措施——启动健康计划的开发与实施,该计划整合了认知、行为、接纳和体验疗法的组成部分。对参与者的可行性、可接受性、体验和治疗过程进行了评估。一小部分参与者的接受度很高,行为改变的初步数据表明,参加该计划的患者从中受益。从基线到10周随访期间,正念练习增加,运动障碍减少,整体感知健康和幸福感也有所改善。参与者表示该计划是可接受的,并且在帮助他们实现个人健康目标方面取得了成功;然而,入学障碍对该计划的出勤可行性产生了负面影响。对入学流程进行修改,例如将转诊信息嵌入电子病历、鼓励配偶或家人共同入学以及同伴辅导,可能会解决这些障碍。启动健康计划有改善健康行为的潜力,并为将有效的行为健康干预措施传播和实施到实际医疗环境中的独特研究铺平了道路。

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