Table 2.
Mean Prevalence of 30 SBS Topic Discussions During Ward Rounds, Expressed as Percentages, from an Observational Study of Social and Behavioral Topics During Attending Rounds, University of California, San Francisco, and Stanford Schools of Medicine, 2012a
| Topic | Mean % per serviceb | Mean % (95% CI) per total (N = 622)b |
P value | |||
|---|---|---|---|---|---|---|
| IM-1 (N = 140) | IM-2 (N = 171) | Peds-1 (N = 186) | Peds-2 (N = 125) | |||
| Health behaviors | ||||||
| Nutrition/diet | 42.9 | 38.9 | 52.8 | 78.2 | 53.2 (48.1–58.6) | < .001 |
| Medical adherence | ||||||
| Referral | 36.3 | 29.4 | 40.5 | 40.0 | 36.3 (30.8–42.3) | .56 |
| Medications | 36.2 | 27.3 | 23.4 | 21.4 | 27.1 (22.0–32.1) | .19 |
| Chronic disease management | 35.4 | 20.4 | 20.7 | 15.2 | 22.9 (17.7–28.2) | .055 |
| Tests/procedures | 24.8 | 15.3 | 14.0 | 26.5 | 20.2 (15.7–24.6) | .12 |
| Primary care follow-up | 20.4 | 10.6 | 3.8 | 16.3 | 12.8 (9.1–16.4) | .012 |
| Exercise | 16.4 | 24.6 | 11.9 | 32.7 | 21.4 (18.1–24.7) | <.001 |
| Home patient safety | 23.3 | 8.1 | 9.5 | 11.1 | 13.0 (9.6–16.3) | .008 |
| Alcohol | 9.8 | 15.3 | 0.5 | 0.0 | 6.4 (4.3–8.5) | <.001 |
| Drugs | 9.3 | 8.9 | 1.1 | 3.2 | 5.6 (3.6–7.6) | .007 |
| Prevention/screening | 0.7 | 3.5 | 2.2 | 12.0 | 4.6 (3.0–6.2) | <.001 |
| Smoking | 7.6 | 10.4 | 0.0 | 0.7 | 4.7 (2.7–6.6) | <.001 |
| Unsafe sexual behavior | 0.7 | 1.2 | 0.5 | 2.4 | 1.2 (0.4–2.1) | .46 |
| Any health behavior topic | 82.8 | 86.6 | 85.5 | 97.6 | 87.6 (--) | -- |
| Social/cultural factors | ||||||
| Social supports | 43.5 | 52.2 | 39.4 | 74.1 | 52.3 (46.8–57.8) | <.001 |
| Resources | 46.5 | 47.1 | 31.8 | 32.0 | 39.4 (34.6–44.1) | .023 |
| Language | 12.2 | 8.5 | 9.4 | 27.8 | 14.5 (11.4–17.6) | <.001 |
| Socioeconomic status | 9.5 | 11.6 | 2.7 | 4.1 | 7.0 (4.8–9.2) | .011 |
| Literacy | 5.8 | 3.7 | 3.3 | 11.1 | 6.0 (3.3–8.7) | .17 |
| Race/ethnicity/cultural | 6.6 | 5.1 | 5.0 | 5.7 | 5.6 (3.5–7.6) | .95 |
| Gender/sexual orientation | 0.0 | 3.6 | 0.5 | 2.7 | 1.7 (0.3–3.1) | .23 |
| Spirituality | 2.9 | 0.6 | 0.0 | 0.8 | 1.1(0.3–1.8) | .069 |
| Any social/cultural topic | 67.1 | 70.2 | 59.1 | 86.4 | 69.4 (--) | -- |
| Mind/body factors | ||||||
| Pain | 57.8 | 67.7 | 36.6 | 84.7 | 61.7 (56.8–66.6) | <.001 |
| Stress | 24.2 | 14.5 | 12.3 | 28.8 | 19.9 (16.2–23.7) | .008 |
| Psychiatric illness | 18.3 | 7.8 | 9.0 | 8.7 | 10.9 (8.1–13.7) | .038 |
| Integrative medicine (CAM) | 1.4 | 3.4 | 0.0 | 13.4 | 4.5 (2.9–6.2) | <.001 |
| Any mind/body topic | 67.1 | 73.1 | 44.6 | 89.6 | 66.6 (--) | -- |
| Behavior change counseling | ||||||
| Patient education | 26.2 | 25.3 | 23.4 | 49.1 | 31.0 (25.8–36.2) | .003 |
| Goal setting | 3.9 | 34.6 | 2.2 | 51.9 | 23.2 (18.7–27.6) | <.001 |
| Assess readiness/enhance motivation | 5.4 | 24.9 | 2.0 | 44.8 | 19.3 (14.3–24.3) | <.001 |
| Shared problem solving | 5.8 | 21.9 | 1.6 | 25.1 | 13.6 (9.9–17.3) | <.001 |
| Self-monitoring | 3.8 | 7.3 | 5.2 | 8.8 | 6.3 (3.9–8.7) | .50 |
| Any behavior change topic | 29.3 | 57.9 | 26.9 | 85.6 | 47.8 (--) | -- |
| Any SBS topic | 97.9 | 98.8 | 94.1 | 98.4 | 97.1 (--) | -- |
Abbreviations: SBS indicates social and behavioral sciences; IM, internal medicine; Peds, pediatrics; N, number of patients; CAM, complementary and alternative medicine.
a
Prevalence (mean frequency) per service was estimated using hierarchical models with team (T = 80) as a random effect and patients (N = 622) nested within teams.
b
N indicates the patient census across 20 teams per service.