Preventive Medicine, Lifestyle, and Health Behavior Change
Core concepts
Know the major modifiable lifestyle domains (diet, physical activity, sleep, tobacco/alcohol, stress, social connection) and their role in primary and secondary prevention. Understand behavior-change frameworks: the transtheoretical (stages of change) model (precontemplation, contemplation, preparation, action, maintenance), motivational interviewing (OARS: open questions, affirmations, reflections, summaries), and self-efficacy/social cognitive theory.
Traps in questions
- Applying the wrong stage-matched intervention: giving action-oriented advice to a precontemplator (should raise awareness, not prescribe a plan).
- Confusing motivational interviewing (collaborative, evoking the patient's own motivation) with confrontational persuasion or education-only counseling.
- Overlooking sleep and social connection as prevention pillars.
- Assuming screening recommendations are uniform-know that they vary by age, risk, and guideline source.
Worked example / rule of thumb
A patient who smokes says, "I know it's bad, but I'm not ready to quit." Rule of thumb: match the intervention to the stage. This is contemplation-use motivational interviewing to explore ambivalence and build motivation; avoid prescribing a quit plan until preparation. Document readiness.
Prevention integration
Connect lifestyle to chronic disease prevention (Domain 8) and special populations (Domain 9). Emphasize shared decision-making and realistic, sustainable goals over perfectionism.