PACE+: interactive communication technology for behavior change in clinical settings.
BACKGROUND
Interactive health communication technologies have the potential to eliminate or greatly reduce many of the barriers to delivery of preventive services. This paper describes the process of developing and evaluating interactive health communication programs for primary care settings. We present as examples the Patient-centered Assessment and Counseling for Exercise plus Nutrition (PACE+) programs, designed to promote physical activity and healthy nutrition with adolescents and adults.


METHODS
The PACE+ programs use interactive communication technology to screen multiple behaviors, prioritize areas for intervention, and initiate intervention. Patient information is synthesized for ease of use by clinicians. The patient completes the program on a computer in the clinic waiting room before the provider encounter. Acceptability of the program was evaluated with adolescents (n=252), adults (n=285), and their health care providers.


RESULTS
The PACE+ programs were developed, evaluated, modified, and re-evaluated. Feasibility testing indicated that a diverse group of adolescents and adults found the PACE+ computer programs acceptable. Modifications to shorten and refine the programs were identified.


CONCLUSIONS
Development of interactive health technologies is an iterative process dependent on feedback from intended users and systems of care. Interactive health communication technologies can be incorporated into clinical settings.
Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, 92120, USA. prochask@sunstroke.sdsu.edu
J J
JJ
Prochaska
M F
MF
Zabinski
K J
KJ
Calfas
J F
JF
Sallis
K
K
Patrick
D000293:Adolescent; D000328:Adult; D003195:Computer Communication Networks; D005069:Evaluation Studies as Topic; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009747:Nutritional Physiological Phenomena; D017060:Patient Satisfaction; D010819:Physician's Role; D011315:Preventive Medicine; D014481:United States