Office system interventions supporting primary care-based health behavior change counseling

Larry L. Dickey, Donald H. Gemson, Patricia Carney

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Content: This article reviews the literature on the effectiveness of office system interventions to improve behavior-change counseling in primary care. These instructions consist of two principle components: tools and teamwork. Tools have been developed to assist providers with health risk assessment (questionnaires, health risk appraisals), prompting and reminding (chart stickers, checklists, flow charts, reminder letters), and education (manuals and handbooks). Teamwork entails the coordination and delegation of tasks between providers and staff. Conclusions: A number of clinical trials, particularly in the area of smoking cessation, have demonstrated the effectiveness of tools and teamwork for increasing counseling rates and counseling effectiveness. Although no one type of tool or method of teamwork is consistently more effective than another - with effectiveness varying according to practice, provider, and patient characteristics - the use of different tools and teamwork approaches leads to additive improvements in counseling and patient behavior-change rates. More high-quality research is needed, particularly in the areas of health risk assessment and electronic reminder systems, to develop effective office interventions that can be readily implemented into a wide variety of primary care practices.

Original languageEnglish (US)
Pages (from-to)299-308
Number of pages10
JournalAmerican journal of preventive medicine
Issue number4
StatePublished - Nov 1999
Externally publishedYes


  • Counseling
  • Health behavior
  • Life change
  • Physician office
  • Primary health care
  • Reminder system
  • Risk assessment

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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