Practical and Relevant Self-Report Measures of Patient Health Behaviors for Primary Care Research

Abstract

PURPOSE With increasing evidence for the value of behavior change counseling, there is a need for health behavior measurements that can be implemented in primary care research. This article discusses criteria for and reviews self-report measures to briefl y assess cigarette smoking, eating patterns, physical activity, and risky drinking across the life course. It then proposes pragmatic measures for use in practice-based research.METHODS Drawing from literature reviews, previous multisite studies, personal communications with experts in the fi eld, and guidance from an expert panel, we identifi ed self-report behavior change measures and gave priority to items that addressed Healthy People 2010 goals, as well as those that were practical (ie, shorter, and easier to score and use for intervention), were sensitive to change, and produced results that could directly inform primary care intervention. RESULTS Separate recommendations are described for measures for adults and for children/adolescents. We recommend a set of 22 items for adults and 16 items for adolescents to track succinctly their status on the 4 health behaviors above. Perfected measures remain elusive: newly developed measures of physical activity and eating patterns are recommended, and in general, the brief measures for adults are currently better validated than are the child measures.CONCLUSIONS A set of totally satisfactory practical instruments for measuring behavior change in primary care settings does not yet exist. There is suffi cient progress to encourage use of and further research on the proposed items. Use of a common set of items across different interventions and projects will help to advance clinical and behavioral research in primary care settings. INTRODUCTIONH ealth behavior counseling in primary care settings holds great potential for disease prevention and management. [1][2][3] Emerging evidence points to the importance of the physician as a change agent, 4 the effi cacy of health behavior change interventions in primary care settings, 5 and the value of behavioral change interventions for high-risk populations. 6 It is timely to emphasize health behavior counseling in primary care given the large potential impact of personal behavior change on premature death and avoidable suffering. 1,7,8 The underperformance of the US health care system is acknowledged and accompanied by keen interest to improve. 9 The 3 primary care medical specialties, as well as primary care nurse practitioners and physician' s assistants, exist in suffi cient numbers to make feasible greater attention to the health needs of primary care patients. [10][11][12] Also, all 3 of the primary care physician specialties-pediatrics, family medicine, and general internal medicine-are now calling for revisions in training Russell E. Glasgow Evaluation of behavioral interventions in primary care research requires appropriate assessments of targeted health behaviors. Valid assessment methods are needed to identify patients who could benefi t from interventions...

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Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

“…Researchers suggest that practicality and acceptability influence the extent to which measures are used in practice (Glasgow et al ., 2005; Holmbeck & Devine, 2009; Lohr, 2002). Practicality is defined as whether the measure can be used despite limited resources (Bowen et al ., 2009), for example, being short and easy to use, and reducing participant and provider burden (Glasgow et al ., 2005; Lohr, 2002).…”