Liana S. Lianov, MD, MPH


August 15, 2011

In This Article

Healthy Behavior Intervention

Among the leading health indicators of Healthy People 2020, the nation's health promotion and disease prevention plan, are physical inactivity, overweight and obesity, tobacco use, and substance abuse.[1] Healthy eating and physical activity are not only essential in preventing disease, but also in the management and treatment of most chronic diseases. In fact, healthy behaviors should be the first line of therapy and prescribed by healthcare providers for both prevention and treatment.

Unfortunately, clinicians do not typically offer lifestyle interventions as first-line management. During regular check-ups, only 36% of obese patients are advised to lose weight, and only 52% of obese patients who already have obesity-related comorbidities are counseled to lose weight.[2] Only 28% of smokers reported that healthcare professionals had offered them assistance in the past year to quit smoking.[3] However, patients report that they would appreciate guidance and assistance from their healthcare providers.[4]

What is hindering lifestyle prescription? Numerous barriers to the implementation of lifestyle medicine prescriptions in clinical practice have been identified. Among them are clinician lack of confidence, skills, and training; inadequate payment; insufficient time during patient visits; and lack of integrated office flow and documentation processes to emphasize healthy behaviors and lifestyle interventions. Additional barriers are healthcare providers' perceptions of lack of effectiveness of office interventions, biases about patient motivation, lack of awareness of community resources, and resistance to change.[5,6,7,8]


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