Rethinking Prevention in Primary Care: Applying the Chronic Care Model to Address Health Risk Behaviors

TLDR

The Chronic Care Model can be adapted to prevent health risk behaviors. The study evaluates the CCM as a framework to prevent tobacco use, risky drinking, poor diet, and inactivity. Data came from primary care practices in a national health promotion initiative funded by the Robert Wood Johnson Foundation. Hospital‑owned practices with a quality‑improvement culture, multispecialty teams, dieticians, decision support, clinical meetings, and EMRs were more likely to provide recommended health‑risk assessment, counseling, and community referrals.

Abstract

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.