Improving Health Habits: Self-Care Priorities
- To evaluate the feasibility and impact of a clinic-based intervention protocol in Los
Angeles county, California, for improving the dietary choices and physical activity
levels of low-income clinic populations in Los Angeles County, California.
OUTLINE: The two participating clinics are randomly assigned to provide care as outlined
below to participants who routinely visit that clinic.
- Arm I (clinic 1, intervention program): Physicians provide health advice to the
participants for 1-2 minutes using a motivational interviewing technique during a
regularly scheduled appointment. Health messages to motivate changes in diet and
physical activity levels are tailored to the participant based on information from the
Patient Health Behavior Priority Assessment (PHBPA). Physicians also create a mutually
agreed upon self-directed lifestyle change plan (the Health Priority Plan) for the
participant using information from the PHBPA. Participants undergo a 10-minute
interview to indicate whether the doctor discussed the plan and their satisfaction with
the visit. After the first clinic encounter, participants are contacted by a health
educator via telephone 4 times over a 2-month period. The telephone sessions are
designed to identify obstacles and challenges in adhering to the Health Priority Plan
and help participants to persevere with the plan. Participants are followed at
baseline, 2 months, and 6 or 12 months. Participants have blood pressure and weight
measured and blood collected to determine levels of nutrients and fat and sugar content
during these follow-up visits.
- Arm II (clinic 2, control program): Physicians provide usual care during a regularly
scheduled appointment. Participants are followed at baseline, 2 months, and 12 months.
Participants have blood pressure and weight measured and a subset of participants also
have blood collected to determine levels of nutrients and fat and sugar content during
these follow-up visits.
In both arms, participants also undergo a 30-minute interview about diet and physical
activity and take a step test to measure heart rate and oxygen level during the follow-up
visits. All participants undergo an exit interview at the end of the study about their
perceptions of the program and what can be improved in the study. Participants' medical
record information is examined for the period of 12 months prior to enrollment in the study,
during the 12-month study period, and for 12 months after the exit interview date.
PROJECTED ACCRUAL: A total of 140 participants (40 for arm I and 100 for arm II) will be
accrued for this study.
Feasibility and impact of a clinic-based intervention protocol for improving the dietary choices and physical activity levels of low-income clinic populations in Los Angeles County, California
Lillian Gelberg, MD, MSPH
Jonsson Comprehensive Cancer Center
|Jonsson Comprehensive Cancer Center at UCLA||Los Angeles, California 90095-1781|