Figure 2. Can Interventions in the Clinical Setting Influence People to Change Their Behavior?

Analytic Framework 2

[D] Select for text description.

Analytic Framework 2—Key Questions:

1. Are there distinct patient groups for whom different assessment and behavioral counseling intervention strategies apply?
2. What patient characteristics (e.g., sociodemographics—including age, race/ethnicity, gender—health status, risk status, behavioral habits, interest in, benefits and barriers to change) are critical to assess prior to behavioral counseling intervention?
3. What are valid, reliable, feasible, and accessible tools for behavioral assessment of patients (and family, as appropriate)?
4. What are adverse effects associated with behavioral assessment?
5. Do behavioral counseling interventions alter health behavior in the targeted group?
6. What are the essential elements of efficacious interventions (i.e., what, how, when, where, to whom, by whom, for how often and for how long?)
7. Are behavioral counseling interventions particularly effective or ineffective in patient subgroups?
8. How long are targeted behavior changes maintained after behavioral counseling intervention?
9. What type of ongoing assistance or supports are need to achieve or maintain targeted behavior changes?
10. Do behavioral counseling interventions produce other positive outcomes (e.g., mediators of behavior change, changes in other health behaviors, improvements in functioning)?
11. What are adverse effects associated with behavioral counseling intervention?
12. Which of the following system influences facilitate/impede behavioral assessment and/or intervention?
    1. Features of the health care team: attitude/motivation, professional discipline(s), skills/training.
    2. Features of the practice setting: practice size and patient make-up, workforce mix, incentives, resources, office support systems, materials.
    3. Features of the health care system: type of organization, location, population characteristics/density, organizational characteristics/policies, administrative arrangements, decision support tools, clinical information systems, incentives, market conditions, community resources, political/legal/regulatory issues, accreditation issues.
13. What are the larger social/environmental influences that determine whether individuals respond to appropriate behavioral counseling interventions and successfully change targeted health behaviors?

Notes:

* An intervention condition is a distinct patient subgroup identified through the assessment process that receives a particular intervention as part of their clinical encounter.
** Evidence for each intervention condition is reviewed in parallel.

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