Skip to main content
SpringerLink
Log in

The Role of Behavioral Medicine in Integrated Healthcare

  • Chapter
  • First Online:
Behavioral Medicine and Integrated Care

Abstract

This chapter reviews evidence from randomized controlled trials that demonstrate the importance of behavioral interventions for improving lifestyle behaviors and preventing and treating chronic diseases. Taking a lifespan approach, we review trials including participants ranging from children to elderly adults, and show that critical components of effective interventions include targeting self-regulation and self-efficacy through strategies such as self-monitoring, receiving feedback, developing action plans, and utilizing effective goal setting strategies. Although limited research exists on comparing the effectiveness of integrating behavioral health experts into the integrated care team, the effects of traditional randomized trials show the consistent effectiveness of implementing behavioral interventions with a high fidelity of delivery. Furthermore, there is a growing literature that supports the cost-effectiveness of behavioral interventions on reducing hospital utilization and medication usage. Thus, the field of behavioral medicine has the potential to play a fundamental role in reducing healthcare utilization and costs by improving lifestyle habits that have been related to the prevention of chronic diseases.

This research was supported in part by the National Institute of Child Health and Human Development (R01HD072153).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27, 379–387.

    Article  PubMed  Google Scholar 

  • Armstrong, M. J., Mottershead, T. A., Ronksley, P. E., Sigal, R. J., Campbell, T. S., & Hemmelgarn, B. R. (2011). Motivational interviewing to improve weight loss in overweight and/or obese patients: A systematic review and meta-analysis of randomized controlled trials. Obesity Reviews, 12, 709–723.

    PubMed  Google Scholar 

  • Ayotte, B. J., Margrett, J. A., & Hicks-Patrick, J. (2010). Physical activity in middle-aged and young-old adults the roles of self-efficacy, barriers, outcome expectancies, self-regulatory behaviors and social support. Journal of Health Psychology, 15, 173–185.

    Article  PubMed  Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prenctice-Hall, Inc.

    Google Scholar 

  • Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31, 143–164.

    Article  Google Scholar 

  • Clark, N. M., Janz, N. K., Dodge, J. A., Schork, M. A., Wheeler, J. R., Liang, J., ... & Santinga, J. T. (1997). Self-management of heart disease by older adults: Assessment of an intervention based on social cognitive theory. Research on Aging, 19, 362–382.

    Article  Google Scholar 

  • Corbin, J. M., & Strauss, A. (1988). Unending work and care: Managing chronic illness at home. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Diabetes Prevention Program Outcomes Study Research Group, Orchard, T. J., Temprosa, M., Barrett-Connor, E., Fowler, S. E., Goldberg, R. B., … Watson, K. E. (2013). Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: A report from the DPP Outcomes Study. Diabetic Medicine, 30, 46–55.

    Article  Google Scholar 

  • Diabetes Prevention Program Research Group. (1999). The Diabetes Prevention Program: Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care, 22, 623–634.

    Article  Google Scholar 

  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393–403.

    Article  Google Scholar 

  • Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374, 1677–1686.

    Article  Google Scholar 

  • Diabetes Prevention Program Research Group. (2012). The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: An intent-to-treat analysis of the DPP/DPPOS. Diabetes, 35, 723–730.

    Google Scholar 

  • Gollwitzer, P. M. (1999). Implementation intentions: Strong effects of simple plans. American Psychologist, 54, 493–503.

    Article  Google Scholar 

  • Gortmaker, S. L., Peterson, K., Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., & Laird, N. (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Archives of Pediatrics & Adolescent Medicine, 153, 409–418.

    Article  Google Scholar 

  • King, A. C., Sallis, J. F., Dunn, A. L., Simons-Morton, D. G., Albright, C. A., Cohen, S., … Coday, M. C. (1998). Overview of the Activity Counseling Trial (ACT) intervention for promoting physical activity in primary health care settings. Medicine & Science in Sports & Exercise, 30, 1086–1096.

    Article  Google Scholar 

  • LeFort, S., Gray-Donald, K., Rowat, K., & Jeans, M. (1998). Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain. Pain, 74, 297–306.

    Article  PubMed  Google Scholar 

  • Look AHEAD Research Group. (2006). The look AHEAD study: A description of the lifestyle intervention and the evidence supporting it. Obesity, 14, 737–752.

    Article  Google Scholar 

  • Look AHEAD Research Group. (2007). Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: One-year results of the look AHEAD trial. Diabetes Care, 30, 1374–1383.

    Article  Google Scholar 

  • Look AHEAD Research Group. (2013). Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes. New England Journal of Medicine, 369, 145–154.

    Google Scholar 

  • Look AHEAD Research Group. (2014a). Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study. Obesity, 22, 5–13.

    Article  Google Scholar 

  • Look AHEAD Research Group. (2014b). Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes. Diabetes Care, 37, 2548–2556.

    Article  Google Scholar 

  • Lorig, K., Gonzalez, V. M., & Ritter, P. (1999). Community-based Spanish language arthritis education program: a randomized trial. Medical Care, 37, 957–963.

    Article  PubMed  Google Scholar 

  • Lorig, K., & Holman, H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26, 1–7.

    Article  PubMed  Google Scholar 

  • Lorig, K. R., Ritter, P., Stewart, A. L., Sobel, D. S., Brown, B. W., Jr., Bandura, A., … Holman, H. R. (2001). Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care, 39, 1217–1223.

    Article  PubMed  Google Scholar 

  • Lorig, K. R., Ritter, P. L., Dost, A., Plant, K., Laurent, D. D., & McNeil, I. (2008). The expert patients programme online, a 1-year study of an internet-based self-management programme for people with long-term conditions. Chronic Illness, 4, 247–256.

    Article  PubMed  Google Scholar 

  • Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Jr., Bandura, A., Ritter, P., … Holman, H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care, 37, 5–14.

    Article  Google Scholar 

  • Luepker, R. V., Perry, C. L., McKinlay, S. M., Nader, P. R., Parcel, G. S., Stone, E. J., ... & Kelder, S. H. (1996). Outcomes of a field trial to improve children’s dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). Jama, 275, 768–776.

    Article  PubMed  Google Scholar 

  • Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S. (2009). Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychology, 28, 690–701.

    Article  PubMed  Google Scholar 

  • Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American Psychologist, 64, 527–537.

    Article  PubMed  Google Scholar 

  • Mitchell, T. B., Amaro, C. M., & Steele, R. G. (2016). Pediatric weight management interventions in primary care settings: A meta-analysis. Health Psychology, 35, 704–713.

    Article  Google Scholar 

  • Pan, X. R., Li, G. W., Hu, Y. H., Wang, J. X., Yang, W. Y., An, Z. X., … Howard, B. V. (1997). Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: The Da Qing IGT and diabetes study. Diabetes Care, 20, 537–544.

    Article  PubMed  Google Scholar 

  • Perry, C. L., Sellers, D. E., Johnson, C., Pedersen, S., Bachman, K. J., Parcel, G. S., ... & Cook, K. (1997). The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation, and feasibility for elementary schools in the United States. Health Education & Behavior, 24, 716–735.

    Article  Google Scholar 

  • Resnicow, K., & McMaster, F. (2012). Motivational interviewing: Moving from why to how with autonomy support. International Journal of Behavioral Nutrition and Physical Activity, 9, 1–9.

    Article  Google Scholar 

  • Resnicow, K., McMaster, F., Bocian, A., Harris, D., Zhou, Y., Snetselaar, L., … Hollinger, D. (2015). Motivational interviewing and dietary counseling for obesity in primary care: An RCT. Pediatrics, 135, 649–657.

    Article  PubMed  Google Scholar 

  • Schroeder, S. (2007). We can do better: Improving the health of the American people. New England Journal of Medicine, 357, 1221–1228.

    Article  PubMed  Google Scholar 

  • Sheeran, P., Klein, W. M., & Rothman, A. J. (2016). Health behavior change: Moving from observation to intervention. Annual Review of Psychology Advance Online Publication.

    Google Scholar 

  • Simons-Morton, D. G., Blair, S. N., King, A. C., Morgan, T. M., Applegate, W. B., O’Toole, M., ... & Shih, J. H. (2001). Effects of physical activity counseling in primary care: The Activity Counseling Trial: A randomized controlled trial. JAMA: Journal of the American Medical Association, 286, 677–687.

    Google Scholar 

  • Spear, B. A., Barlow, S. E., Ervin, C., Ludwig, D. S., Saelens, B. E., Schetzina, K. E., & Taveras, E. M. (2007). Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics, 120, S254–S288.

    Article  PubMed  Google Scholar 

  • Stead, L. F., Bergson, G., & Lancaster, T. (2008). Physician advice for smoking cessation Cochrane review. London: The Cochrane Library.

    Google Scholar 

  • Stoto, M. A. (2013). Population health in the Affordable Care Act era. Washington, DC: AcademyHealth.

    Google Scholar 

  • Suhrcke, M., Nugent, R. A., Stuckler, D., & Rocco, L. (2006). Chronic disease: An economic perspective. London: Oxford Health Alliance.

    Google Scholar 

  • Sweeney, A. M., Wilson, D. K., & Lee Van Horn, M. (2017). Longitudinal relationships between self-concept for physical activity and neighborhood social life as predictors of physical activity among older African American adults. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 67.

    Google Scholar 

  • Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., … Salminen, V. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344, 1343–1350.

    Article  PubMed  Google Scholar 

  • Wilson, D. K., Kitzman-Ulrich, H., Williams, J. E., Saunders, R., Griffin, S., Pate, R., … Sisson, S. B. (2008). An overview of “The Active by Choice Today” (ACT) trial for increasing physical activity. Contemporary Clinical Trials, 29, 21–31.

    Article  PubMed  Google Scholar 

  • Wilson, D. K., Trumpeter, N. N., St George, S. M., Coulon, S. M., Griffin, S., Lee Van Horn, M., … Gadson, B. (2010). An overview of the “Positive Action for Today’s Health” (PATH) trial for increasing walking in low income, ethnic minority communities. Contemporary Clinical Trials, 31, 624–633.

    Article  PubMed  Google Scholar 

  • Wilson, D. K., Van Horn, M. L., Kitzman-Ulrich, H., Saunders, R., Pate, R., Lawman, H. G., ... & Mansard, L. (2011). Results of the “Active by Choice Today”(ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychology, 30, 463–471.

    Article  PubMed  Google Scholar 

  • Wilson, D. K., Van Horn, M. L., Siceloff, E. R., Alia, K. A., St George, S. M., Lawman, H. G., … Gadson, B. (2015). The results of the “Positive Action for Today’s Health” (PATH) trial for increasing walking and physical activity in underserved African-American Communities. Annals of Behavioral Medicine, 49, 398–410.

    Article  PubMed  Google Scholar 

  • Wilson, D.K, Christensen, A., Jacobson, P., & Kaplan, R.M. (2018). Special Issue on Standards for Economic Analyses for the Field of Health Psychology and Behavioral Medicine. Health Psychology. 

    Google Scholar 

  • Woolf, S. H., & Aron, L. (Eds.). (2013). US health in international perspective: Shorter lives, poorer health. Bethesda, MD: National Academies Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA

    Dawn K. Wilson & Allison M. Sweeney

Authors
  1. Dawn K. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Allison M. Sweeney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dawn K. Wilson .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Nevada, Reno, Reno, NV, USA

    Melanie P. Duckworth

  2. Department of Psychology, University of Nevada, Reno, Reno, NV, USA

    William T. O'Donohue

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wilson, D.K., Sweeney, A.M. (2018). The Role of Behavioral Medicine in Integrated Healthcare. In: Duckworth, M., O'Donohue, W. (eds) Behavioral Medicine and Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93003-9_2

Download citation

Publish with us

Policies and ethics

Search

Navigation