Background

The Affordable Care Act provides Medicare Part B beneficiaries access to cost-free Annual Wellness Visits (AWVs). Patients receive health behavior recommendations from a Personalized Prevention Plan (PPP) during AWV encounters.

Aims

To identify factors clinical pharmacists can use to influence adoption of PPPs in primary care practices.

Method

Utilizing a cross-sectional design, 77 Medicare patients (mean age 74.05 ± 8.04 years) presenting for subsequent AWV completed a theory of planned behavior (TPB) based questionnaire at two primary care practices.

Results

66.2% reported they were in the process of implementing PPPs and 51.9% reported implementing recommendations in the previous 12 months. TPB constructs accounted for 35.8% (p < .001) of the variation in intention, with subjective norm (SN) (β = 0.359, p = 0.004) as the strongest determinant, followed by attitude (β = 0.195, p = 0.093), and perceived behavioral control (PBC) (β = 0.103, p = 0.384). Intention accounted for 27.1% of the variance for implementing PPPs and was not a significant determinant (β = 0.047, p = 0.917). Addition of past behavior with TPB constructs significantly improved the predictability of the TPB model, accounted for 55% of the variation in intention (p < .001), and demonstrated a significant positive influence (β = 0.636, p < 0.001) on future PPP implementations.

Discussion

This study demonstrates utility of the TPB in predicting implementation of PPPs. Conclusions. Clinical pharmacists positioned as providers of AWVs can strengthen intention to adopt PPPs by integrating referents into AWV processes, and evaluating past behavior trends to improve future PPP implementation.

中文翻译：

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使用计划行为理论影响年度健康访问患者个性化预防计划实施的因素：一项定量研究

背景

《平价医疗法案》为联邦医疗保险 B 部分的受益人提供免费年度健康访问 (AWV)。在 AWV 遭遇期间，患者会从个性化预防计划 (PPP) 中获得健康行为建议。

宗旨

确定临床药师可以用来影响在初级保健实践中采用 PPP 的因素。

方法

利用横断面设计，77 名参加后续 AWV 的 Medicare 患者（平均年龄 74.05 ± 8.04 岁）在两个初级保健机构完成了基于计划行为理论 (TPB) 的问卷调查。

结果

66.2% 的受访者表示他们正在实施 PPPs，51.9% 的受访者表示在过去 12 个月内实施了建议。TPB 结构占意图变异的 35.8% (p < .001)，主观规范 (SN) (β = 0.359, p = 0.004) 是最强的决定因素，其次是态度 (β = 0.195, p = 0.093) , 和感知行为控制 (PBC) (β = 0.103, p = 0.384)。意图占实施 PPP 方差的 27.1%，并且不是重要的决定因素（β = 0.047，p = 0.917）。将过去的行为与 TPB 结构相加显着提高了 TPB 模型的可预测性，占意图变异的 55% (p < .001)，并显示出对未来 PPP 的显着积极影响 (β = 0.636, p < 0.001)实现。

讨论

本研究证明了 TPB 在预测 PPP 实施方面的效用。结论。定位为 AWV 提供者的临床药师可以通过将参考对象整合到 AWV 流程中来增强采用 PPP 的意愿，并评估过去的行为趋势以改进未来的 PPP 实施。