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Behavioral Counseling Interventions
Figure 2. Can Interventions in the Clinical Setting Influence People to Change Their Behavior?
Analytic Framework
![This flow chart was designed to answer a question: Can interventions in the clinical setting influence people to change their behavior? Key questions are listed below. For an explanation of the image, go to text description [D].](framework2.gif)
[D] Select for text description.
Analytic Framework—Key Questions:
- Are there distinct patient groups for whom different assessment and behavioral counseling intervention strategies apply?
- 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?
- What are valid, reliable, feasible, and accessible tools for behavioral assessment of patients (and family, as appropriate)?
- What are adverse effects associated with behavioral assessment?
- Do behavioral counseling interventions alter health behavior in the targeted group?
- 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?)
- Are behavioral counseling interventions particularly effective or ineffective in patient subgroups?
- How long are targeted behavior changes maintained after behavioral counseling intervention?
- What type of ongoing assistance or supports are need to achieve or maintain targeted behavior changes?
- Do behavioral counseling interventions produce other positive outcomes (e.g., mediators of behavior change, changes in other health behaviors, improvements in functioning)?
- What are adverse effects associated with behavioral counseling intervention?
- Which of the following system influences facilitate/impede behavioral assessment and/or intervention?
- Features of the health care team: attitude/motivation, professional discipline(s), skills/training.
- Features of the practice setting: practice size and patient make-up, workforce mix, incentives, resources, office support systems, materials.
- 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.
- 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.
