Access Type

Open Access Dissertation

Date of Award

January 2019

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

First Advisor

Annmarie Cano

Abstract

There is a growing need to address the difficulties that people face trying to engage in a healthier lifestyle and the integration of behavioral health into primary care settings may offer an opportunity to address this need. Health behavior change groups may be an effective style of intervention in medical settings; however, the experiences patients have attending these groups as well as how health behavior change groups best fit into integrated care settings is largely unknown. The purpose of the current study was to offer a preliminary test of feasibility and acceptability for a group intervention, conducted in a primary care setting, that aimed to teach skills that initiate health behavior change. The developed group, The Kickstart Health (KSH) Program, is a multicomponent approach to initiating behavior change based on the tenets of the Health Beliefs Model (Rosenstock, 1990). The program proposed to increase exercise, improve nutrition, and decrease stress with a person-centered, experiential approach that utilized a flexible enrollment schedule. Of the patients who enrolled in the study (N = 22), thirteen attended at least one session of the program. Patients attended, on average, 3.78 sessions over the course of 8 months and those who attend the group differed in some ways from those who did not attend. Patients who never attended KSH (n = 8) were more likely to report that being tired (M = 2.38, SD = 0.74) and lazy (M = 2.50, SD = 0.76) were reasons to not exercise compared to who those who attended. Overall, patients perceived KSH as acceptable and satisfactory, and KSH was feasibly integrated into a primary care setting with minimal additional costs to facilities with established behavioral health care providers. Promising results were found in increasing overall perceptions of health, well-being, and engagement in mindfulness meditation. However, physicians reported that they were less satisfied with the referral process and integration of the program. In addition to difficulties with the referral process and patient-reported logistical barriers (i.e., transportation and time), cognitive barriers and negative beliefs about oneself may have also impacted attendance. Future research may consider utilizing therapeutic techniques during the recruitment phase to increase attendance to health behavior change groups delivered in primary care settings.

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