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To provide a rationale regarding the importance of physician behavior change counseling. To describe the double helix behavior change curriculum at the University of Rochester (UR). To provide initial evidence that the curriculum is effective.

Evidence that physician use of the 5A's model is effective in changing important patient health behaviors is summarized. The behavior change curriculum is described. Initial evidence assessing knowledge, attitudes and skills for behavior change counseling is reviewed.

Physicians will be better prepared to intervene to improve their patients quality and quantity of life if they consistently counsel patients using a brief standard model (the 5A's) that integrates biological, psychological, and social aspects of disease and treatment. Past efforts in the UR's curriculum have demonstrated that students adopt broader “biopsychosocial values” when the curriculum supports their learning needs. Initial evidence demonstrates that double helix curriculum students learn this model well and are able to provide the counseling in a patient‐centered style.

These results are limited by the observational design, and the reliance on student self‐reports and standardized patient observations of student behavior rather than change in patient behavior.

Strong evidence exists that physicians can be effective in providing behavior change counseling. Additional research is called for to create, implement, and fully evaluate behavior change counseling curricula for medical students.

An example of a behavior change curriculum is provided for medical educators, and initial evidence of its effectiveness is provided.

To assess the effect of diagnostic testing for coronary artery disease (CAD) on motivation for change, and on lifestyle change for patients with chest pain.

This observational study followed patients with chest pain suggestive of CAD for three years. Constructs of autonomous and controlled motivation for lifestyle change, autonomous orientation, and autonomy support from self‐determination theory were assessed. Self‐reported tobacco use, physical activity, and diet were assessed at baseline and three years later. Physician rating of pre‐ and post‐test probability of CAD were also assessed. CAD diagnosis was established after three years.

Physicians' autonomy‐supportive style and patients' autonomous orientations both predicted greater patient autonomous motivation, which in turn predicted improved diet, more exercise, and marginally less smoking. High probability of CAD also led patients to become more autonomously motivated for lifestyle change.

The observational nature of the study and the self‐report measures of health behaviors preclude causal conclusions from this study. Findings from this study suggest that patient motivation and risk behavior are affected by results of cardiac testing, by physicians' support of autonomy, and by patients' personalities.

Physicians may be effective in motivating behavior change around time of testing for CAD.

The self‐determination theory model for health behavior change accounted for change in patient health risk behavior change around the time of testing for CAD. Physicians and researchers might use these results to design and test interventions for practitioners to effectively motivate behavior change around the time of medical tests.

The purpose of this paper is to describe how tailoring financial incentives for healthy behaviors to employees’ goals, values, and aspirations might improve the efficacy of incentives.

The authors integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee’s life goals, values, or aspirations.

Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed.

Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. The strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. The authors outline necessary research to examine the effectiveness of this approach among at-risk employees.

Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees’ autonomous motivation for sustained health improvements.

Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost.

The approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors.

This article focuses on one court case concerning the regulation of Anti-Abortion protesting and asks: (1) Do the various actors involved in this case recognize a tension between their actions and their broader beliefs concerning the regulation of political protests? (2) If this tension is recognized, how do the actors resolve it, and if it is not recognized, why is it not? While concerned with legal consciousness and cognitive dissonance, the article is framed by broader questions concerning tolerance and the interaction of law and political passions.

The librarian and researcher have to be able to uncover specific articles in their areas of interest. This Bibliography is designed to help. Volume IV, like Volume III, contains features to help the reader to retrieve relevant literature from MCB University Press' considerable output. Each entry within has been indexed according to author(s) and the Fifth Edition of the SCIMP/SCAMP Thesaurus. The latter thus provides a full subject index to facilitate rapid retrieval. Each article or book is assigned its own unique number and this is used in both the subject and author index. This Volume indexes 29 journals indicating the depth, coverage and expansion of MCB's portfolio.

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

From earliest times the land and all it produced to feed and sustain those who dwelt on it was mankind's greatest asset. From the Biblical “land of milk and honey”, down through history to the “country of farmers” visualised by the American colonists when they severed the links with the mother country, those who had all their needs met by the land were blessed — they still are! The inevitable change brought about by the fast‐growing populations caused them to turn to industry; Britain introduced the “machine age” to the world; the USA the concept of mass production — and the troubles and problems of man increased to the present chaos of to‐day. There remained areas which depended on an agri‐economy — the granary countries, as the vast open spaces of pre‐War Russia; now the great plains of North America, to supply grain for the bread of the peoples of the dense industrial conurbations, which no longer produced anything like enough to feed themselves.

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.