title: The impact of behavioral and mental health risk assessments on goal setting in primary care.
abstract: Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p < 0.001), set goals for six risks (range of differences 3.8-16.6 %, p < 0.01), and improve five risks (range of differences 5.4-13.6 %, p < 0.01). Compared to controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.Trial RegistrationClinicaltrials.gov identifier: NCT01825746.
authors.affiliation: Department of Family Medicine and Population Health, Virginia Commonwealth University, PO Box 980101, Richmond, VA, 23298, USA. ahkrist@vcu.edu.
authors.forename: Alex H
authors.initials: AH
authors.lastname: Krist
authors.affiliation: Department of Family Medicine, University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Russell E
authors.initials: RE
authors.lastname: Glasgow
authors.affiliation: Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Heurtin-Roberts
authors.affiliation: Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.|Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Roy T
authors.initials: RT
authors.lastname: Sabo
authors.affiliation: School of Public Health, University of Maryland, College Park, MD, USA.
authors.forename: Dylan H
authors.initials: DH
authors.lastname: Roby
authors.affiliation: Division of Cancer Control and Population Sciences (Leidos Biomedical Research, Inc.), National Cancer Institute, Rockville, MD, USA.
authors.forename: Sherri N Sheinfeld
authors.initials: SN
authors.lastname: Gorin
authors.affiliation: Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX, USA.
authors.forename: Bijal A
authors.initials: BA
authors.lastname: Balasubramanian
authors.affiliation: Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA, USA.|Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Estabrooks
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Sciences Center School of Public Health, College Station, TX, USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.affiliation: Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Glenn
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Phillips
authors.affiliation: Department of Family Medicine, University of Vermont, Burlington, VT, USA.
authors.forename: Rodger
authors.initials: R
authors.lastname: Kessler
authors.affiliation: Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA, USA.|Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA.
authors.forename: Sallie Beth
authors.initials: SB
authors.lastname: Johnson
authors.affiliation: Consortium for Implementation Science, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Rohweder
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006040:Goals; D015438:Health Behavior; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008603:Mental Health; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D015397:Program Evaluation; D018570:Risk Assessment; D055815:Young Adult
keywords: Health behaviors; Health risk assessment; Mental health; Patient reported measures; Pragmatic trial; Primary care