Linking Practice and Community Through a Focus on Capability (Text Ver
Linking Practice and Community Through a Focus on Capability
Robert L. Ferrer, MD, MPH
Dept. of Family & Community Medicine
University of Texas Health Science Center at San Antonio
A Medical Assistant-Based Program to Promote Healthy Behaviors in Primary Care
- Robert Ferrer, MD, MPH.
- Sherrie Gott, PhD.
- Priti Mody-Bailey, MD, MA.
- Carlos Jaén, MD, PhD.
- Sara Araujo, BA.
- Melissa Talamantes, MS.
Annals of Family Medicine 2009;7:544-512.
Service Outcomes: % Attending Interventions
Behavioral Outcomes: % of Patients Improved
- The practical opportunities to live the life one wishes.
Images of two book covers by Amartya Sen are also shown.
Image of a flowchart with the following information:
Inputs (Means to achieve):
- Available goods & services.
- Community resources.
- Income and other assets.
- Built environment.
- Functional status.
- Social support.
Capability Set (Freedom to achieve):
- Opportunity set of achievable functioning.
Achieved functioning (Achievement).
Adapted from Robeyns, 2005.
- Q: Why can't you go walking?
- A: Because I don't know how to drive.
Physicians' Advice on Healthy Behaviors
|Doctor encourages healthy eating||93.8|
|Doctor encourages physical activity||93.5|
|Doctor understands how hard to be physically active||56.8|
|Doctor understands how hard to eat healthy||37.3|
Opportunities for Healthy Behaviors
|Available fruit & vegetables where I shop||95.9|
|Easy to get to food store||85.6|
|Local fruit & vegetables of high quality||74.3|
|Can afford fresh fruit & vegetables||69.9|
|Can afford lean meat & fish||57.0|
|Nearby outdoor physical activity||71.9|
|Easy to walk places in neighborhood||57.2|
|Nearby indoor physical activity||49.8|
|Feel safe walking after dark||27.3|
Barriers to Healthy Behaviors
|Partner sometimes forbids physical activity||14.0|
|Partner sometimes refuses healthy foods||30.6|
|Too tired to cook own meals||32.2|
|Care of family leaves little time for physical activity||35.3|
|Not treated with respect||38.6|
|Illness gets in way of physical activity||55.5|
|Feeling depressed keeps from physical activity||56.4|
|Can’t afford groceries over whole month||70.8|
Multiple Vulnerabilities: Healthy Eating
1. No grocery in neighborhood.
2. Groceries too expensive over whole month.
3. Little time to prepare own meals.
4. Family doesn't allow to eat recommended foods.
81.2% have 2 or more
|# present||% of sample|
Image: An elementary school is shown.
Image: A whiteboard is shown.
Image: Fruits, vegetables, and juices are shown.
Image: A pot of soup is shown.
Image: Two doors are shown.
Image: A number of computers and monitors are shown.