Rethinking prevention in primary care: Applying the chronic care model to address health risk behaviors

Dorothy Y. Hung, Thomas G. Rundall, Alfred F. Tallia, Deborah J. Cohen, Helen Ann Halpin, Benjamin F. Crabtree

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


This study examines the Chronic Care Model (CCM) as a framework for preventing health risk behaviors such as tobacco use, risky drinking, unhealthy dietary patterns, and physical inactivity. Data were obtained from primary care practices participating in a national health promotion initiative sponsored by the Robert Wood Johnson Foundation. Practices owned by a hospital health system and exhibiting a culture of quality improvement were more likely to offer recommended services such as health risk assessment, behavioral counseling, and referral to community-based programs. Practices that had a multispecialty physician staff and staff dieticians, decision support in the form of point-of-care reminders and clinical staff meetings, and clinical information systems such as electronic medical records were also more likely to offer recommended services. Adaptation of the CCM for preventive purposes may offer a useful framework for addressing important health risk behaviors.

Original languageEnglish (US)
Pages (from-to)69-91
Number of pages23
JournalMilbank Quarterly
Issue number1
StatePublished - Jan 2007
Externally publishedYes


  • Chronic Care Model
  • Health promotion/disease prevention
  • Health risk behaviors
  • Primary care practice

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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