Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-24T00:41:57.309Z Has data issue: false hasContentIssue false
  • English
  • Français

General Practitioners as Agents of Health Risk Behaviour Change: Opportunities for Behavioural Science in Patient Smoking Cessation

Published online by Cambridge University Press:  06 October 2014

John H. Wiggers  and
Rob Sanson-Fisher
John H. Wiggers*
Affiliation:
University of Newcastle
Rob Sanson-Fisher*
Affiliation:
University of Newcastle
*
The Secretary, Discipline of Behavioural Science in Relation to Medicine, Faculty of Medicine, University of Newcastle, Locked Bag No 10, Wallsend NSW 2287, Australia
The Secretary, Discipline of Behavioural Science in Relation to Medicine, Faculty of Medicine, University of Newcastle, Locked Bag No 10, Wallsend NSW 2287, Australia
Get access

Abstract

General practitioners have been suggested as occupying a position in the community that offers considerable potential for reducing the prevalence of health risk behaviours. Green, Eriksen, and Schor (1988) have proposed that if general practitioners are to effectively adopt a role in modifying patient health risk behaviours, a number of prerequisite conditions must be met. Using the model proposed by Green et al., this paper reviews the literature to describe the circumstances under which general practitioners currently practise this role. The review focuses on the circumstances relating to practitioner modification of one patient health risk behaviour: smoking. Research detailing the extent of practitioner involvement in the modification of this risk behaviour is also reviewed. The paper concludes by discussing the opportunities available for behavioural scientists to facilitate general practitioners' adoption of a role in patient smoking cessation.

Type
Research Article
Information
Behaviour Change , Volume 11 , Issue 3 , September 1994 , pp. 167 - 176
Copyright
Copyright © The Author(s) 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adodian, D., Silverberg, D.S., Turner, D., Wamosher, Z. (1990). Group discussions with the health care team — a method of improving care of hypertension in general practice. Journal of Human Hypertension, 4, 265–268.Google Scholar
Australian Cancer Society. (1993). A national cancer prevention policy for Australia. Sydney: Author.Google Scholar
Australian Institute of Health and Welfare. (1992). Australia's Health 1992. The Third Biennial report. Canberra: Australian Government Publishing Service.Google Scholar
Australian Medical Association (1987). Policies of the Australian Medical Association and Directory for 1987–1988. Sydney: Author.Google Scholar
Bauman, A., Mant, A., Middleton, L., Mackertich, M., & Jane, E. (1989). Do general practitioners promote health?: A needs assessment. Medical Journal of Australia, 151, 262–269.Google Scholar
Bowman, J., Redman, S., Dickinson, J., Gibberd, R., & Sanson-Fisher, R. (1991). The accuracy of Pap Smear utilisation self-report: A methodological consideration in cervical cancer screening. Health Services Research, 26, 97–107.Google Scholar
Canadian Task Force on the Periodic Health Examination (1979). The periodic health examination. Canadian Medical Association Journal, 121, 1194–1254.Google Scholar
Chapman, S. (1990). General practitioner anti-smoking programs: Which one? Medical Journal of Australia, 152, 508–509.Google Scholar
Chapman, S. (1993). The role of doctors in promoting smoking cessation. British Medical Journal, 307, 518–519.CrossRefGoogle ScholarPubMed
Chu, F.Z., & Day, R.G. (1981). Smoking recognition by family physicians. Journal of Family Practice, 12, 657–660.Google Scholar
Cockburn, J., Killer, D., Campbell, E., & Sanson-Fisher, R.W. (1987). Measuring general practitioners' attitudes towards medical care. Family Practice, 4, 192–199.Google Scholar
Cockburn, J., Reid, A., & Sanson-Fisher, R. (1987). The process and content of general-practice consultations that involve prescription of antibiotic agents. Medical Journal of Australia, 147, 431–324.CrossRefGoogle ScholarPubMed
Cockburn, J., Ruth, D., Silagy, C., Dobbin, M., Reid, Y., Scollo, M., & Naccarella, L. (1992). Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners. British Medical Journal, 304, 691–694.CrossRefGoogle ScholarPubMed
Commonwealth Department of Health, Housing, Local Government, and Community Services (1993). Accrediting general practice. Securing quality for the future: Principles for establishing an accreditation system. Canberra: Author.Google Scholar
Copeman, R.C., Swannell, R.J., Princus, D.F., & Woodhead, K.A. (1989). Utilisation of the smokescreen smoking cessation programme by general practitioners and their patients. Medical Journal of Australia, 151, 83–87.Google Scholar
Cumming, R.G., Barton, G.E., Fahey, P.P., Wilson, A., & Leeder, S.R. (1989). Medical practitioners and health promotion: Results from a community survey in Sydney's western suburbs. Community Health Studies, 13, 294–300.CrossRefGoogle ScholarPubMed
Cummings, S.R., Coates, T.J., Richard, R.J., Hansen, B., Zahnd, E.G., Van der Martin, R., Duncan, C., Gerbert, B., Martin, A., & Stein, A. (1989). Training physicians in counselling about smoking cessation. A randomised trial of the ‘Quit for Life’ programme. Annals of Internal Medicine, 110, 640–647.Google Scholar
Dickinson, J.A., Hall, J., Logan, J., & McDonald, M.L. (1984). An economic model of general practice. Medical Journal of Australia, 140, 652–658.Google Scholar
Dickinson, J.A., Wiggers, J., Leeder, S.R., & Sanson-Fisher, R.W. (1989). General practitioners' detection of patients' smoking status. Medical Journal of Australia, 150, 420–426.Google Scholar
Dietrich, A.J., O'Connor, G.T., Keller, A., Carney, P.A., Levy, D., & Whaley, F.S. (1992). Cancer: Improving early detection and prevention. A community practice randomized trial. British Medical Journal, 304, 687–691.Google Scholar
Ewart, C.K., Li, V.C., & Coates, T.J. (1983). Increasing physicians' anti-smoking influence by applying an inexpensive feedback technique. Journal of Medical Education, 58, 468–473.Google Scholar
Family Heart Study Group. (1994). Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: Principal results of British family heart study. British Medical Journal, 308, 313–320.Google Scholar
Fiore, M.C., Epps, R.S., & Manley, M.W. (1994). A missed opportunity. Teaching medical students to help their patients successfully quit smoking. Journal of the American Medical Association, 271, 624–626.Google Scholar
Fleming, D.M., & Lawrence, M.S. (1981). An evaluation of recorded information about preventive measures in 38 practices. Journal of the Royal College of General Practitioners, 31, 615–620.Google ScholarPubMed
Flemming, D.M., & Lawrence, M.S. (1983). Impact of audit on preventive measures, and other characteristics, British Medical Journal, 287, 1852–1854.Google Scholar
Fowler, G., Mant, D., Fuller, A., & Jones, L. (1989). The ‘Help Your Patient Stop’ initiative: Evaluation of smoking prevalence and dissemination of WHO/UICC guidelines in UK general practice. Lancet, 1, 1253–1255.Google Scholar
Fullard, E., Fowler, G., & Gray, M. (1987). Promoting prevention in primary care: Controlled trial of low technology, low cost approach. British Medical Journal, 294, 1080–1082.Google Scholar
Gilpin, E., Pierce, J., Goodman, J., Giovino, G., & Berry, C. (1992). Trends in physicians' giving advice to stop smoking, United States, 1974-87. Tobacco Control, 1, 31–36.Google Scholar
Glynn, T.J., Boyd, G.M., & Gruman, J.C. (1990). Essential elements of self-help/minimal intervention strategies for smoking cessation. Health Education Quarterly, 17, 329–345.Google Scholar
Goldberg, R.J., Ockene, I.S., Ockene, J.K., Merriam, P., & Kristeller, J. (1993). Physicians attitudes and reported practices towards smoking intervention. Journal of Cancer Education, 8, 133–139.Google Scholar
Gordon, J.G., Saunders, N.A., Hennrikus, D., & Sanson-Fisher, R.W. (1992). Interns' performance with simulated patients at beginning and end of the intern year. Journal of General Internal Medicine, 7, 51–62.Google Scholar
Green, L.W. (1984). Modifying and developing health behaviours. In Breslow, L., Fielding, J.A., & Lave, L.B. (Eds.), Annual Review of Public Health, (Vol. 5, pp. 215–236). Palo Alto, CA: Annual Reviews, Inc.Google Scholar
Green, L.W., Eriksen, M.P., & Schor, E.L. (1988). Preventive practices by physicians: Behavioral determinants and potential interventions. American Journal of Preventive Medicine, 4 (Supp), 101–104.Google ScholarPubMed
Haynes, R.B., Davis, D.A., McKibbon, A., & Tugwell, P.A. (1984). Critical appraisal of the efficacy of continuing medical education. Journal of the American Medical Association, 251, 61–64.CrossRefGoogle ScholarPubMed
Haynes, R.B., & Walker, C.J. (1987). Computer-aided quality assurance: A critical appraisal. Archives of Internal Medicine, 147, 1297–1304.Google Scholar
Heywood, A., Ring, I., & Sanson-Fisher, R. (In press). Screening for cardiovascular disease and risk reduction counselling behaviours of general practitioners. Preventive Medicine, 23, 292–301.Google Scholar
Hill, D.J., & Borland, R. (1989). Are doctors doing enough to stop their patients smoking? Medical Journal of Australia, 150, 413–414.Google Scholar
Imperial Cancer Research Fund OXCHECK Study Group. (1994). Effectiveness of health checks conducted by nurses in primary care: Results of the OXCHECK study after one year. British Medical Journal, 308, 308–312.Google Scholar
Kenney, R.D., Lyles, M.F., Turner, R.C., White, S., Gonzalez, S., Irons, T., Sanchez, C., Rogers, C., Campbell, E., Villagra, V., Strecher, V., O'Malley, M., Stritter, F., & Fletcher, S. (1988). Smoking cessation counselling by resident physicians in internal medicine, family practice, and pediatrics. Archives of Internal Medicine, 148, 2469–73.Google Scholar
Kottke, T.E., Battista, R.N., DeFriese, G.H., & Brekke, M.L. (1988). Attributes of successful smoking cessation interventions in medical practice: A meta-analysis of 39 controlled trials. Journal of the American Medical Association, 259, 2882–2889.Google Scholar
Kottke, T.E., Solberg, L.I., & Brekke, M.L. (1990). Initiation and maintenance of patient behavioural change: What is the role of the physician? Journal of General Internal Medicine, 5, S62–S67.Google Scholar
Kottke, T.E., Solberg, L.I., Conn, S., Maxwell, P., Thomasberg, M., & Brekke, M.J. (1990). A comparison of two methods to recruit physicians to deliver smoking cessation interventions. Archives of Internal Medicine, 150, 1477–1481.Google Scholar
Lawrence, R.S. (1990). Diffusion of the US Preventive Services Task Force Recommendation into practice. Journal of General Internal Medicine, 5, S99–S103.Google Scholar
Lawrence, M., Coulter, A., & Jones, L. (1990). A total audit of preventive procedures in 45 practices caring for 430 000 patients. British Medical Journal, 300, 1501–1503.Google Scholar
Lomas, J., & Haynes, R.B. (1988). A taxonomy and critical review of tested strategies for the application of clinical practice recommendations: From ‘official’ to ‘individual’ clinical policy. America Journal of Preventive Medicine, 4(Suppl), 77–94,Google Scholar
Lomas, J. (1991). Words without action? The production, dissemination, and impact of consensus recommendations. Annual Review of Public Health, 12, 41–65.Google Scholar
Magnus, P. (1989). Cigarette smoking and the Australian medical profession. Medical Journal of Australia, 150, 437–441.Google Scholar
Manley, M., Epps, R.P., Husten, C., Glynn, T., & Shopland, D. (1991). Clinical interventions in tobacco control. Journal of the American Medical Association, 266, 3172–3173.Google Scholar
Mattick, R.P., & Baillie, A. (1992). An outline of approaches to smoking cessation. Canberra: Australian Government Publishing Service.Google Scholar
McPhee, S.J., Bird, J.A., Fordham, D., Rodnick, J.E., & Osborn, E.H. (1991). Promoting cancer prevention activities by primary care physicians: Results of a randomised, controlled trial. Journal of the American Medical Association, 266, 538–544Google Scholar
National Forum for Coronary Heart Disease Prevention. (1988). Coronary heart disease prevention: Action in the UK 1984–7. London: Health Education Authority.Google Scholar
National Health and Medical Research Council. (1981). Report of the 91st session of the Council. Canberra: Australian Government Printing Service.Google Scholar
National Smoking and Heart Disease Committee of the National Heart Foundation of Australia. (1989). Canberra: National Heart Foundation.Google Scholar
Nutting, P.A. (1986). Health promotion in primary medical care: Problems and potential. Preventive Medicine, 15, 537–548.Google Scholar
Owen, N. (1989). Behavioural intervention studies and behavioural epidemiology research to improve smoking-cessation strategies. Health Education Research, 4, 145–153.Google Scholar
Pomerlau, O.F., & Pomerlau, C.S. (1977). Break the smoking habit. Champaign, IL: Research Press Company.Google Scholar
Rappaport, J. (1977). Community psychology: Values, research, action. New York: Holt, Rinehart, & Winston.Google Scholar
Richmond, R., & Heather, N. (1990). General practitioner interventions for smoking cessation: Past results and further prospects. Behaviour Change, 7, 110–119.Google Scholar
Roche, A.M. (1993). Drug and alcohol medical education: Skills training for brief and early intervention. Unpublished doctoral dissertation, University of Newcastle, Newcastle.Google Scholar
Romm, F., & Putnam, S. (1981). The validity of the medical record. Medical Care, 19, 310–315.Google Scholar
Royal Australian College of General Practitioners. (1986). Policy 50 — Tobacco smoking and advertising. Jolimont, Vic: Author.Google Scholar
Royal Australian College of General Practitioners. (1993). Guidelines for preventive activities in general practice. Jolimont, Vic: Author.Google Scholar
Sanson-Fisher, R.W., & Maguire, P. (1980). Should skills in communicating with patients be taught in medical schools? Lancet, 2, 523–526.Google Scholar
Sanson-Fisher, R.W., Schofield, M.J., & Perkins, J. (1993). Behaviour therapy's role in preventing physical illness. Behaviour Change, 10, 25–31.Google Scholar
Sanson-Fisher, R., Webb, G.R., & Reid, A.L.A. (1986). The role of the medical practitioner as an agent of disease prevention. In Better Health Commission: Looking forward to better health (Vol. 3, pp. 201–212). Canberra: Australian Government Publishing Service.Google Scholar
Schwartz, J.L. (1987). Review and evaluation of smoking cessation methods: The United States and Canada 1978–1985. NIH publication No. 87-2940. Baltimore, MD: National Institute of Health.Google Scholar
Silagy, C. (1989). Utilization of the ‘Smokescreen’ smoking-cessation programmme. Medical Journal of Australia, 151, 486.Google Scholar
Silagy, C., Muir, J., Coulter, A., Thorogood, M., Yudkin, P., & Roe, L. (1992). Lifestyle advice in general practice: Rates recalled by patients. British Medical Journal, 305, 871–874.Google Scholar
Slama, K., Redman, S., Cockburn, J., & Sanson-Fisher, R.W. (1989). Community views about the role of general practitioners in disease prevention. Family Practice, 6, 203–209.Google Scholar
Slama, K., Redman, S., Perkins, S., Reid, A.L., & Sanson-Fisher, R.W. (1990). The effectiveness of two smoking cessation programmes for use in general practice: A randomised clinical trial. British Medical Journal, 300, 1707–1709.Google Scholar
U.S. Preventive Services Task Force. (1989) Guide to clinical preventive services. Baltimore, MD: Williams and Wilkins.Google Scholar
Ward, J.E., Gordon, J., & Sanson-Fisher, R.W. (1991). Strategies to increase preventive care in general practice. Medical Journal of Australia, 154, 523–531.CrossRefGoogle ScholarPubMed
Weller, D.P., Litt, J.C.B., Pols, R.G., Ali, R.L., Southgate, D.O., & Harris, R.D. (1992). Drug and alcohol related health problems in primary care – what do GPs think? Medical Journal of Australia, 156, 43–48.CrossRefGoogle ScholarPubMed
Weschler, H., Levine, S., Idelson, R.K., Rohman, M., & Taylor, J.O. (1983). The physicians' role in health promotion — a survey of primary care practitioners. New England Journal of Medicine, 308, 97–100.Google Scholar
Wilson, D., Wakefield, M., Steven, I., Rohrsheim, R., Esterman, A., & Graham, N. (1990). ‘Sick of Smoking’: Evaluation of a targeted minimal smoking cessation intervention. Medical Journal of Australia, 152, 518–521.Google Scholar
World Health Organisation. (1993). Increasing the relevance of education for health professionals: Report of the WHO study group on problem-solving education for the health profession. WHO Technical Report Series No. 838. Geneva: Author.Google Scholar
Zuckerman, A., Starfield, B., Hochreiter, C., & Kovasznay, B. (1975). Validating the content of paediatric outpatient medical records by means of tape-recording doctor-patient encounters. Paediatrics, 56, 407–411.Google Scholar