The BETTER Program has developed several tools for primary care clinicians in order to facilitate their chronic disease prevention and screening efforts.
All of the following tools were identified or developed by BETTER’s Clinical Working Group through a rigorous process involving review of the literature and tools available in the primary care setting for prevention and screening and identifying those that had the highest level of evidence. These tools are available as resources to clinicians undertaking the Prevention Practitioner role and included as part of the BETTER Toolkit.
The BETTER Tools
The Spaghetti Diagram
Published by Haydon et al. in 2006, the Spaghetti Diagram is an illustration of the inter-connectivity of modifiable risk factors and chronic disease. This serves as a visual depiction of the complexity of care patients require in order to properly address chronic disease.
The BETTER Algorithm
The BETTER Algorithm combines all of the evidence-based maneuvers used in BETTER for a proactive and comprehensive approach. Two algorithms are available – for diabetic and non-diabetic patients – which provide the specific chronic disease prevention and screening maneuvers used in BETTER, their associated targets and corresponding care paths.
The BETTER Health Survey
Focusing on information that is usually not well documented in patient charts, the BETTER health survey includes tools to capture a detailed prevention and screening history for risk factors such as smoking, physical activity, diet, alcohol, and family history. The survey is typically completed by the patient before their visit with the Prevention Practitioner, but can also be verbally administered by a member of the practice team in cases where there are literacy concerns.
References for the validated tools embedded in the BETTER Health Survey can be found here.
The Bubble Diagram
The Bubble Diagram is a visual representation of the BETTER Algorithm and provides gender specific targets. Visually intuitive, the Bubble Diagram can be used as a patient teaching tool to illustrate the patient’s individual risk factors for chronic disease.
The BETTER Prevention Prescription and The BETTER Patient Goals Sheet
The Prevention Prescription provides a summary for both the clinician and the patient of the patient’s risk for chronic disease, their discussion with the Prevention Practitioner and in conjunction with the Goals Sheet, provides the patient and clinician with a plan geared toward enabling the patient to achieve their chronic disease prevention and screening goals. In particular, the Goals Sheet is used as a patient action planning tool, allowing patients to reflect on the barriers they may face while trying to achieve their chronic disease prevention and screening goals and how they will overcome them.
The BETTER NWT Program Resources
To facilitate the implementation of the BETTER Program in the Northwest Territories, healthcare professionals, policy makers and content experts were brought together in the North to create lifestyle pathways for use by practitioners to help patients make lifestyle changes. Used with patients who, as a result of the Health Prevention Visit, have a positive screen (i.e. are out of target) for physical activity, weight management, smoking or alcohol consumption, these pathways allow practitioners to actively engage patients in their health, particularly in settings where access to resources may be limited.
More information about the BETTER NWT Program and other programs currently ongoing in the Northwest Territories can be found on the ChooseNWT website.
Other resources in the BETTER Toolkit
Additional resources were also identified by the Clinical Working Group and included in the BETTER Toolkit. These include existing local, regional and national resources that can be referred to and/or distributed to patients. For a listing of these additional resources, please visit our Suggested Resources and Links page.
BETTER Program Resources
Electronic copies of the BETTER Tools are available upon request. To request a copy of the tools please contact us.
The BETTER website and tools are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
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