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.

Keywords: Health behaviors; Health risk assessment; Mental health; Patient reported measures; Pragmatic trial; Primary care.

Figures

Fig. 1

CONSORT MOHR study flow diagram. CONSORT study flow diagram for this practice-level randomized controlled trial. All practices randomized to the intervention were able to field the MOHR assessment. Practices offered MOHR to patients presenting for a wellness and/or chronic care visit. Using an intention to treat approach, all patients presenting for a wellness and/or chronic care visit were offered the outcomes survey—whether or not they completed the intervention. Once 150 patients completed the survey, survey administration was discontinued, even if the practice continued to MOHR assessment