title: Clinician assessment, advice and referral for multiple health risk behaviors: prevalence and predictors of delivery by primary health care nurses and allied health professionals.
abstract: OBJECTIVE
  Primary care clinicians have considerable potential to provide preventive care. This study describes their preventive care delivery.
  
  
  METHODS
  A survey of 384 community health nurses and allied health clinicians from in New South Wales, Australia was undertaken (2010-11) to examine the assessment of client risk, provision of brief advice and referral/follow-up regarding smoking inadequate fruit and vegetable consumption, alcohol misuse, and physical inactivity; the existence of preventive care support strategies; and the association between supports and preventive care provision.
  
  
  RESULTS
  Preventive care to 80% or more clients was least often provided for referral/follow-up (24.7-45.6% of clinicians for individual risks, and 24.2% for all risks) and most often for assessment (34.4-69.3% of clinicians for individual risks, and 24.4% for all risks). Approximately 75% reported having 9 or fewer of 17 supports. Provision of care was associated with: availability of a paper screening tool; training; GP referral letter; and number of supports.
  
  
  CONCLUSIONS
  The delivery of preventive care was limited, and varied according to type of care and risk. Supports were variably associated with elements of preventive care.
  
  
  CONCLUSIONS
  Further research is required to increase routine preventive care delivery and the availability of supports.
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Faculty of Health, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia. Electronic address: Megan.Freund@hnehealth.nsw.gov.au.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McElwaine
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Faculty of Health, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia. Electronic address: Megan.Freund@hnehealth.nsw.gov.au.
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Faculty of Health, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia. Electronic address: Libby.Campbell@hnehealth.nsw.gov.au.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Campbell
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia. Electronic address: Carolyn.Slattery@hnehealth.nsw.gov.au.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Slattery
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Faculty of Health, The University of Newcastle, Newcastle, Australia; Faculty of Science and Information Technology, The University of Newcastle, Newcastle, Australia. Electronic address: Paula.Wye@hnehealth.nsw.gov.au.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Wye
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia. Electronic address: Christophe.Lecathelinais@hnehealth.nsw.gov.au.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lecathelinais
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia; Faculty of Science and Information Technology, The University of Newcastle, Newcastle, Australia. Electronic address: Kate.Bartlem@hnehealth.nsw.gov.au.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Bartlem
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia. Electronic address: Karen.Gillham@hnehealth.nsw.gov.au.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Gillham
authors.affiliation: Population Health, Hunter New England Local Health District, Newcastle, Australia; Faculty of Health, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Clinical Research Centre, Newcastle, Australia. Electronic address: John.Wiggers@hnehealth.nsw.gov.au.
authors.forename: John H
authors.initials: JH
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009726:Nurses; D057184:Practice Patterns, Nurses'; D015995:Prevalence; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D000074606:Smoking Prevention; D014675:Vegetables; D055815:Young Adult
keywords: Community health services; Delivery of health care; Health care providers; Health risk behaviors; Heath prevention