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Healthy People 2010 - With Annotations

Clinical Preventive Care


1-3. (Developmental) Increase the proportion of persons appropriately counseled about health behaviors.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

Substantial gaps remain in the delivery of appropriate screening and counseling services related to health behaviors. Unhealthy diets, smoking, physical inactivity, and alcohol use account for a majority of preventable deaths in the United States.(36) Data indicate that risk assessment and counseling interventions are delivered less frequently than other preventive interventions (for example, cancer screenings).(12) In addition, the attention physicians give to specific health-risk behaviors appears to be influenced by the socioeconomic status of their patients.(37) Although time is an important constraint in the primary care setting, evidence demonstrates that brief clinician counseling is effective in getting patients to stop smoking and reduce problem drinking.(1, 38) In addition, more intensive dietary counseling can lead to reduced dietary fat and cholesterol intake and increased fruit and vegetable consumption.(1) Effective primary care-based interventions to increase physical activity have been more difficult to identify.(1, 39)

Some evidence shows that provider counseling can increase the use of seat belts, child safety seats, and bicycle helmets, especially when directed to parents of infants and young children.(1) Brief counseling interventions aimed at high-risk individuals can increase condom use and prevent new sexually transmitted diseases.(40)

Clinician counseling should be tailored to the individual risk factors, needs, preferences, and abilities of each patient.(1) For some preventive interventions, such as hormone therapy in post-menopausal women, the optimal strategy depends on how individual patients value potential benefits and risks. Counseling of perimenopausal and postmenopausal women should encourage shared decisionmaking based on individual risk factors and patient preferences.(1)

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Rev. 19-Aug-2001 at 20:19 hours.