title: Care provision to prevent chronic disease by community mental health clinicians.
abstract: BACKGROUND
  People with a mental illness have higher prevalence of behavioral risks for chronic disease than the general population. Despite recommendations regarding the provision of preventive care by mental health services, limited research has examined the extent to which such care is provided.
  
  
  OBJECTIVE
  To examine mental health clinician provision of care for preventable chronic disease risks, and whether such care was associated with the availability of practice support strategies.
  
  
  METHODS
  A cross-sectional survey was undertaken of 151 community mental health clinicians in New South Wales, Australia regarding the provision of three elements of preventive care (i.e., assessment, brief advice, and referral/follow-up) for four health risk behaviors (i.e., tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Clinicians reported the availability of 16 strategies to support such care delivery. Data were collected in 2010 and analyzed in 2012-2013.
  
  
  RESULTS
  Preventive care provision varied by both care element and risk behavior. Optimal care (each care element provided to at least 80% of clients for all health behaviors) was provided by few clinicians: assessment (8.6%), brief advice (24.5%), and referral/follow-up (9.9%). Less than half of clinicians reported more than four support strategies were available (44.4%). The availability of five or more strategies was associated with increased optimal preventive care.
  
  
  CONCLUSIONS
  The provision of preventive care focused on chronic disease prevention in community mental health services is suboptimal. Interventions to increase the routine provision of such care should involve increasing the availability of evidence-based strategies to support care provision.
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. Electronic address: kate.bartlem@hnehealth.nsw.gov.au.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Bartlem
authors.affiliation: School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Bowman
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Wye
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McElwaine
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Campbell
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Gillham
authors.affiliation: Population Health, Hunter New England Local Health District, Wallsend Health Services, Wallsend; Faculty of Health, The University of Newcastle, Callaghan; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: John H
authors.initials: JH
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D003158:Community Psychiatry / Q000379:methods*; D015897:Comorbidity; D003695:Delivery of Health Care / Q000458:organization & administration*; D037001:Directive Counseling / Q000379:methods; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D020380:Needs Assessment; D009517:New South Wales / Q000453:epidemiology; D015596:Nutrition Assessment; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology