چکیده (انگلیسی):

Background:Screening of primary care patients for unhealthy behaviors and mental health issues is recommended
by numerous governing bodies internationally, yet evidence suggests that provider-initiated screening is not routine
practice. The objective of this study was to implement systematic pre-screening of primary care patients for common
preventive health issues on a large scale.
Methods:Patients registered for non-acute visits to one of 40 primary care providers from eight clinics in an Academic
Medical Center health care network in the United States from May, 2012 to May, 2014 were contacted one- to three-days
prior to their visit. Patients were invited to complete a questionnaire using an Interactive Voice Response (IVR) system. Six
items assessed pain, smoking, alcohol use, physical activity, concern about weight, and mood.
Results:The acceptance rate among eligible patients reached by phone was 65.6 %, of which 95.5 % completed the
IVR-Screen (N= 8,490; mean age 57; 57 % female). Sample demographics were representative of the overall primary
care population from which participants were drawn on gender, race, and insurance status, but participants were
slightly older and more likely to be married. Eighty-seven percent of patients screened positive on at least one item,
and 59 % endorsed multiple problems. The majority of respondents (64.2 %) reported being never or only somewhat
physically active. Weight concern was reported by 43.9 % of respondents, 36.4 % met criteria for unhealthy alcohol use,
23.4 % reported current pain, 19.6 % reported low mood, and 9.4 % reported smoking.
Conclusions:The percent endorsement for each behavioral health concern was generally consistent with studies
of screening using other methods, and contrasts starkly with the reported low rates of screening and intervention
for such concerns in typical PC practice. Results support the feasibility of IVR-based, large-scale pre-appointment
behavioral health/ lifestyle risk factor screening of primary care patients. Pre-screening in this population facilitated
participation in a controlled trial of brief treatment for unhealthy drinking, and also could be valuable clinically because
it allows for case identification and management during routine care.