From The New England Journal of Medicine
This book is an important contribution to the growing literature on health promotion and disease prevention. It successfully brings together the theoretical basis of health promotion and disease prevention and practical formulas for changing the behavior of patients. Clinicians will find it a well-balanced primer. In the foreword to the book, Breslow observes that most physicians now in practice were educated in the ``complaint-response circumstance.'' By this he means that clinical encounters are driven by responses consisting largely of diagnostic and therapeutic interventions. Such reactions are frequent in tertiary care, in which established disease is treated. By contrast, Talking about Health and Wellness with Patients focuses on primary and secondary prevention.
In the introductory chapter, Jonas introduces his 10 central concepts of health promotion and disease prevention. These are as follows: Health is a state of being and wellness a process of being; health status is determined by a broad range of factors; health has a natural history; central to wellness is a wide array of interventions; success in certain endeavors to change behavior is relative; risks to health can be reduced, and in few instances is the outcome certain; achieving balance is the essence of healthy living and wellness; there is a common pathway to success in most efforts to change personal behavior; motivation is a process, not a thing; and assessment, goal setting, and mobilizing motivation are the central tasks in changing personal behavior.
Jonas divides these concepts into the first seven, which are common denominators of health and well-being, and the last three, which are important for changing personal health-related behavior. The first seven concepts are a useful way for practitioners to understand the theoretical essentials of health, wellness, and the promotion of health and the integration of the theory into clinical practice. An important objective of the last three concepts is to suggest to the practitioner an approach to changing patients' behavior. After discussing the 10 central concepts, Jonas explains how they can be integrated into clinical practice, using the promotion of exercise as an example. The book ends with a chapter on the changes necessary to integrate health promotion and disease prevention into clinical practice.
Talking about Health and Wellness with Patients is based on sound scientific concepts and practices. Its publication coincides with a time in which many Americans are seeking to improve their health, achieve wellness, and prevent disease. Practicing clinicians are often asked to respond to these goals with interventions based on their own understanding of the theoretical foundations of health promotion. This book not only provides the requisite information succinctly and authoritatively but also presents guidelines for implementation. These features also make the book suitable for a course in clinical prevention.
Pascal James Imperato, M.D., M.P.H.&T.M.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.