By Jessica Cerretani

Patients are likely to change their unhealthy behaviors for the better after visiting a website containing health advice sponsored by their physician's practice, according to a study published in the March/April 2006 issue of the Annals of Family Medicine. Referring patients to such a website can be a useful adjunct to giving traditional in-office health advice, say the researchers.

Unhealthy behaviors such as poor diet, inactivity, tobacco use, and alcohol abuse are common problems in the United States. However, encouraging patients to improve these behaviors can be difficult. Challenges faced by clinicians include time constraints during office visits, limited reimbursement, and the ability to connect patients with quality, unbiased health information. Although patients may want to change unhealthy habits, they may lack the appropriate tools and motivation to do so.

To determine whether visiting a practice-sponsored website containing tailored health advice could help facilitate behavior change in patients, Virginia researchers followed 6 primary care practices over the course of 9 months. They encouraged adult patients of these practices with unhealthy habits to visit a website that had been specially created for this study. The website featured an intake assessment that collected a behavioral history, a resource library, links to additional resources, and individually tailored advice. A control group of patients from other practices was directed to static web pages that contained limited information.

A total of 932 patients visited the website and 273 of them enrolled in the study. The majority of these patients reported physical inactivity and a poor diet as their unhealthy behaviors, and more than half of them said they wanted their physician's help in changing these habits. After 4 months, readiness to change and improved health behaviors had increased in both the intervention and the control patients. Intervention patients reported greater improvements than control patients after 1 month, but these differences did not persist throughout the study.

This study also highlights patient interest in practice-sponsored websites. Of the intervention group, 64 percent said they liked the website, and more than half visited the site 2 to 5 times. When asked to recommend improvements to the website, patients said they would like more detailed information and requested more interaction with clinicians. Although more study is needed, such online interactivity between patients and physicians may provide further benefit for patients in health behavior change and maintenance. "The secure integration of practice and consumer information systems offers a modern vehicle for what were once separate interventions, e.g., patient education, decision aids, patient reminders, and clinician prompts," say the researchers. They suggest that a practice website should act as an adjunct to, rather than a substitute for, physician care. Electronic tools "would presumably yield their greatest benefit as part of an integrated suite of tools that practices would offer patients," they write.

"This study adds to the growing body of evidence that patients are most engaged in their care and hence able to achieve positive outcomes when their providers support recommendations with Internet-based tools," says L. Eleanor J. Herriman, MD, MBA, NorthPoint Domain's Chief Science Officer. "This is a key component of the evolving practice delivery model of 'informed care.'"

NorthPoint Domain remains a leader in the development of physician-directed patient education and informed care through its Accelerator Resource Center (ARC) and Patient Literacy Center (PLC) and a forerunner in e-communications between patients and physicians with its Secure Messaging Center (SMC). In addition to articles about specific conditions, tests, and treatments, the PLC features information on how patients can improve their overall health through risk factor management articles that contain advice on exercise, weight loss, and smoking cessation. NorthPoint Domain's wellness library, Take Control of Your Health, also offers easy-to-read lifestyle information, such as tips on healthy eating, being physically active, and reducing stress. To learn more about the ARC, PLC, and SMC, visit NorthPoint Domain.

Source: Woolf SH, Krist AH, Johnson RE, et al. 2006. A practice-sponsored Web site to help patients pursue healthy behaviors: an ACORN study. Annals of Family Medicine 4:148-152.

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