Clinician assessment, advice and referral for multiple health risk behaviors: prevalence and predictors of delivery by primary health care nurses and allied health professionals

Objective: Primary care clinicians have considerable potential to provide preventive care. This study describes their preventive care delivery. Methods: A survey of 384 community health nurses and allied health clinicians from in New South Wales, Australia was undertaken (2010–11) to examine the assessment of client risk, provision of brief advice and referral/follow-up regarding smoking inadequate fruit and vegetable consumption, alcohol misuse, and physical inactivity; the existence of preventive care support strategies; and the association between supports and preventive care provision. Results: Preventive care to 80% or more clients was least often provided for referral/follow-up (24.7–45.6% of clinicians for individual risks, and 24.2% for all risks) and most often for assessment (34.4–69.3% of clinicians for individual risks, and 24.4% for all risks). Approximately 75% reported having 9 or fewer of 17 supports. Provision of care was associated with: availability of a paper screening tool; training; GP referral letter; and number of supports. Conclusion: The delivery of preventive care was limited, and varied according to type of care and risk. Supports were variably associated with elements of preventive care. Practice implications: Further research is required to increase routine preventive care delivery and the availability of supports.