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Innovations Tackle Physical Inactivity, Smoking, Poor Diet, and Risky Drinking Through Primary Care
Press Release Date: August 22 2003
The Robert Wood Johnson Foundation (RWJF) and the Agency for Healthcare Research and Quality (AHRQ) announced today the first round of grants awarded through Prescription for Health, a research initiative supported by both organizations. The new multiyear project is designed to develop effective, practical strategies that primary care providers can use to help Americans change their unhealthy behaviors.
Research shows that unhealthy behaviors account for 40 percent of premature deaths in this country. More than 46.5 million American adults continue to smoke, despite the well-known risks, while nearly 14 million adults drink too much alcohol, raising their risk for liver disease, accidents, and trauma. Over 60 percent of American adults are overweight and nearly 40 percent are too sedentary—increasing their susceptibility to heart disease, diabetes, and high blood pressure.
"Primary care providers who see patients every day have enormous power to motivate people to make healthy lifestyle changes," said J. Michael McGinnis, M.D., senior vice president and director of RWJF's health group. "We hope that these innovative projects help those on the front lines of health care lead the way for active, healthy living."
In the first phase of the new program, 17 primary care practice-based research networks (PBRNs)—groups of medical practices that affiliate with each other to improve health care quality though research—received grants to design and test innovative projects to help primary care providers (e.g., physicians, nurse practitioners and physician assistants) help patients become more physically active, eat healthier foods, avoid or quit smoking, and use alcohol in moderation. Each project must identify strategies that can be applied in routine primary care practice that address at least two risky behaviors.
Collaborating with RWJF on the Prescription for Health program, AHRQ and the National Institutes of Health's Office of Behavioral and Social Science Research have funded a Resource Center to expand the capacity of the PBRNs as they create the systems and infrastructure needed to develop and test new strategies. The resource center is directed by the Indiana University School of Medicine and the National Opinion Research Center.
"We must bring the power of primary care to help Americans reduce unhealthy behaviors and improve their overall health," said Carolyn Clancy, M.D., director of AHRQ. "This is a major priority for HHS Secretary Tommy G. Thompson, and this partnership with RWJF will result in evidence-based information and tools that will help achieve this critical goal."
Larry Green, M.D., director of Prescription for Health and a professor of family medicine at the University of Colorado, said, "We need a revolution in human health behavior, and primary care physicians are in a perfect position to help incite that revolution. Most people go to their primary care provider for most of their health care. These visits and these relationships are great opportunities to address patients' health behaviors."
The 16-month innovation grants are each for $125,000. For a list of grantees, go to http://www.prescriptionforhealth.org/grantees/index.html. The innovations include new tools, cues and strategies that redesign primary care to focus on health-related behaviors. The target populations that the projects will affect are diverse with respect to age, gender, geography, race, ethnicity, socioeconomic status, and insurance status.
Examples of innovations include:
- Creation of new types of staff positions, such as community health advisors who link patients to specific local opportunities.
- Prescribed Web sites that give patients ways to access information, local resources, and assistance from their doctor.
- A PDA tool to help clinicians tailor counseling to the particular patient they are seeing.
- Links to community resources that provide regularly scheduled counseling by phone matched to each patient's stage of adaptation.
- PDA-based assessment of health risks for adolescents with E-mail followup.
"By coming up with even a handful of effective innovations, primary care clinicians can improve and extend the lives of millions of people," Dr. Green said.
Only PBRNs were eligible to apply for the grants. The 17 grantees were selected from 70 proposals. A subsequent call for proposals to be issued near the end of 2004 will solicit a second round of innovation grants, as well as further studies to test and refine promising first-round innovations.
For more information about the grant awards and the Prescription for Health program, please visit http://www.prescriptionforhealth.org.
The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse—tobacco, alcohol, and illicit drugs.
The Agency for Healthcare Research and Quality, a part of the U.S. Department of Health and Human Services, is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, improve patient safety, address medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access.
For more information, please contact AHRQ Press Office: Karen Migdail, (301) 427-1855 (KMigdail@ahrq.gov); RWJF Public Affairs: (609) 627-5937.