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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 9 No. 5, May 2000   Archives  •  Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (96)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Drug Therapy  • Adherence  • Treatment Adherence  • Randomized Controlled Trial  • Alert me on articles by topic How Does Physician Advice Influence Patient Behavior? Evidence for a Priming Effect Matthew W. Kreuter, PhD, MPH; Shobhina G. Chheda, MD, MPH; Fiona C. Bull, PhD Arch Fam Med. 2000;9:426-433. Objective  To explore a potential "priming effect" of physician advice on patient responses to behavioral change interventions. Design  Randomized controlled trial with a 3-month follow-up. Setting  Four community-based group family medicine clinics in southeastern Missouri. Participants  Adult patients (N=915). Interventions  Printed educational materials designed to encourage patients to quit smoking, eat less fat, and increase physical activity. Main Outcome Measures  Recall, rating, and use of the educational materials; changes in smoking behavior, dietary fat consumption, and physical activity. Results  Patients who received physician advice to quit smoking, eat less fat, or get more exercise prior to receiving intervention materials on the same topic were more likely to remember the materials, show them to others, and perceive the materials as applying to them specifically. They were also more likely to report trying to quit smoking (odds ratio [OR]=1.54, 95% confidence interval [CI]=0.95-2.40), quitting for at least 24 hours (OR=1.85, 95% CI=1.02-3.34), and making some changes in diet (OR=1.35, 95% CI=1.00-1.84) and physical activity (OR=1.51, 95% CI=0.95-2.40). Conclusions  Findings support an integrated model of disease prevention in which physician advice is a catalyst for change and is supported by a coordinated system of information and activities that can provide the depth of detail and individualization necessary for sustained behavioral change. From the Health Communication Research Laboratory, Department of Community Health, School of Public Health, Saint Louis University (Drs Kreuter and Bull), and the Department of Internal Medicine, Division of General Internal Medicine, School of Medicine, Saint Louis University Health Sciences Center (Dr Chheda), St Louis, Mo. 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