Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleOriginal Research

Behavior-Change Action Plans in Primary Care: A Feasibility Study of Clinicians

Kate MacGregor, Margaret Handley, Sharon Wong, Claire Sharifi, Ken Gjeltema, Dean Schillinger and Thomas Bodenheimer
The Journal of the American Board of Family Medicine May 2006, 19 (3) 215-223; DOI: https://doi.org/10.3122/jabfm.19.3.215
Kate MacGregor
MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Margaret Handley
PhD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sharon Wong
MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Claire Sharifi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ken Gjeltema
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dean Schillinger
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas Bodenheimer
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1.
    • Download figure
    • Open in new tab
    Figure 1.

    The Action Plan Form 〈www.familymedicine.medschool.ucsf.edu/research/research_programs/actionPlan.aspx〉.

Tables

  • Figures
    • View popup
    Table 1.

    Action Plan Completion Rates and Post-Visit Questionnaires

    Safety Net (n = 128) (%)Private Practice (n = 146) (%)Overall (n = 274) (%)
    Completed action plans828483
    Clinician post-action plan discussion questionnaires returned929292
        For patients with action plan939393
        For patients without action plan868786
    Clinician reasons for not completing action plans*
        Patient too ill441529
        Too little time285039
        Patient not interested171013
        Other112518
    Clinician satisfaction with discussion†
        No different than previous behavior change discussions322428
        Less satisfying than previous discussions867
        More satisfying than previous discussions425047
        Not applicable‡161616
        Question not answered<143
    Estimated time to complete action plan discussions (minutes)§Safety Net (n = 93)Private Practice (n = 113)Overall (n = 216)
    AverageRangeAverageRangeAverageRange
    6.91 to 206.81 to 206.91 to 20
    SD4.54.14.32
    • * Mantel-Haenszel χ2; P = .03

    • † Response to question: ′Was today’s discussion about behavior change more satisfying, less satisfying, or no different than previous behavior change discussions with this patient (or not applicable)?′

    • ‡ Patients for whom an action plan was not developed for reasons of time, patient illness, new patient, etc.

    • § For 12 action plans discussions, clinicians did not estimate the time; thus the n = 216 rather than 228.

    • View popup
    Table 2.

    Clinician Post-study Questionnaire Responses

    a. In general, do you feel that action plans make behavior change discussions:
    Easier?The same?Harder?
        Private practice (N = 21)52%43%5%
        Safety net (N = 18)61%22%17%
        Overall (N = 39)56%33%10%
    Clinician Post-study Ratings of the Acceptability and Usability of Action Plan Methods
    YesNo
    b. Did the study change the way you like to discuss health behavior with patients?
        Private practice62%38%
        Safety net89%11%
        Overall74%26%
    c. Did you use action plans with patients outside the study?
        Private practice76%24%
        Safety net72%28%
        Overall74%26%
    d. Have you recommended the action plan idea to other clinicians?
        Private practice43%57%
        Safety net22%78%
        Overall33%67%
    e. Will you continue to use the action plan with some of your patients?
        Private practice81%19%
        Safety net83%17%
        Overall82%18%
    f. Should all primary care clinicians be trained in the use of action plans?
        Private practice86%14%
        Safety net89%11%
        Overall87%13%
    Clinician Post-study Assessment of Action Plan Effectiveness
    g. Do you think Action Plans can be helpful in encouraging behavior change?NoRare patientsSome patientsMost patients
        Private practice0%0%67%33%
        Safety net0%6%59%35%
        Overall0%3%64%33%
    Clinician Post-study Assessment of Barriers to Goal-setting Discussions
    h. What is the barrier that makes it most difficult to use Action Plans in primary care visits?*TimeMethods†OtherResources
        Private practice67%38%10%5%
        Safety net65%41%0%29%
        Overall66%39%5%21%
    Clinician Opinion on Goal-setting by Other Health Caregivers
    i. Do you think it would be more appropriate for other caregivers to engage patients in goal setting since physicians have very little time?YesNo
        Private practice (N = 21)52%48%
        Safety net (N = 18)67%33%
        Overall (N = 39)59%41%
    j. If “Yes,” what type of caregiver would be appropriate?Health EducatorsMedical AssistantsNursesSocial Workers
        Private practice67%29%57%29%
        Safety net67%33%61%39%
        Overall67%31%59%33%
    • * More than one barrier was identified by some clinicians.

    • † Methods refers to difficulties associated with using action plan forms and engaging in collaborative discussions.

    • View popup
    Table 3.

    Sample Clinician Quotes from Post-Study Semistructured Interviews

    TopicQuotesPractice Setting
    Time“… that was the big inhibition for me—the time factor. When patients come here they often have four or five issues, and you can’t add another thing.”Private practice
    “… it’s difficult when it’s busy and it’s difficult not to be directive. Being directive doesn’t take much time.”Private practice
    “… [the action plan] helped me prioritize that as opposed to the 16 other priorities …”Safety net
    Resources“It would be kind of nice to have an appointment just to talk about the action plan.”Private practice
    “Anything that adds more paper is a problem.”Safety net
    “[The action plan] made it more real and achievable for patients to set goals … and by doing that and calling them back a week later it was extremely helpful for them… . It would be really nice if we could continue that. We don’t have the resources to do that.”Private practice
    General comments“It would be hard to totally let [the action plan] be patient-driven.”Safety net
    “I get to the point where I say, ‘The action plan is you’re going to take a lipid-lowering medicine, you’re going to take it for 4 weeks, here’s the lab slip.’ ”Private practice
    “The emphasis on getting patients to assume some responsibility for their own care is good.”Private practice
    “… paring down to one thing, pin it down, that was a shift for me.”Safety net
    “[The action plan] really gives you a chance for buy in and I found it’s more successful to give them a chance to talk about their health and what’s important for them, so I like it.”Safety net
    “When a patient didn’t do the action plan I was flummoxed. I didn’t know what to do next.”Private practice
    “I really felt like [the action plan] impacted the way I did health education with lots and lots of patients … ”Safety net
    “I felt disappointed when patients did not reach their goals, even if they only did 50%.”Private practice
    “If an action plan comes up naturally in a visit then it’s a good idea.”Private practice
    “I like the concept, but most doctors, and probably myself, will do [action plans] for a while and then go back to the old pattern of yelling at the patients to change their behaviors—because that is how we were taught.”Private practice
    Other caregivers“I think [the action plan] would be much better for the non-clinician to do, because of time.”Private practice
    “I think it would be empowering for our nurses to do action plans when they’re not busy doing other stuff.”Safety net
    “… if we had our nurse and MAs trying to do [action plans] it would slow things down even more.”Safety net
    “All those medical assistants, health educators, social workers, that would be awesome if they could [do action plans] before or after the visit.”Private practice
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family Medicine: 19 (3)
The Journal of the American Board of Family Medicine
Vol. 19, Issue 3
May-June 2006
  • Table of Contents
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Behavior-Change Action Plans in Primary Care: A Feasibility Study of Clinicians
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
5 + 7 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Behavior-Change Action Plans in Primary Care: A Feasibility Study of Clinicians
Kate MacGregor, Margaret Handley, Sharon Wong, Claire Sharifi, Ken Gjeltema, Dean Schillinger, Thomas Bodenheimer
The Journal of the American Board of Family Medicine May 2006, 19 (3) 215-223; DOI: 10.3122/jabfm.19.3.215

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Behavior-Change Action Plans in Primary Care: A Feasibility Study of Clinicians
Kate MacGregor, Margaret Handley, Sharon Wong, Claire Sharifi, Ken Gjeltema, Dean Schillinger, Thomas Bodenheimer
The Journal of the American Board of Family Medicine May 2006, 19 (3) 215-223; DOI: 10.3122/jabfm.19.3.215
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Examining Variations in Action Plan Quality Among Adults With Type 2 Diabetes in Primary Care
  • Improving Diabetes Self-Management Support: Goal-Setting Across the Continuum of Care
  • Understanding the Quality Chasm for Hypertension Control in Diabetes: A Structured Review of "Co-maneuvers" Used in Clinical Trials
  • The Teamlet Model of Primary Care
  • Helping Patients Adopt Healthier Behaviors
  • Using Action Plans to Help Primary Care Patients Adopt Healthy Behaviors: A Descriptive Study
  • Google Scholar

More in this TOC Section

  • Successful Implementation of Integrated Behavioral Health
  • Identifying and Addressing Social Determinants of Health with an Electronic Health Record
  • Integrating Adverse Childhood Experiences and Social Risks Screening in Adult Primary Care
Show more Original Research

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire