1. An orientation toward optimizing health as well as the traditional concept of diagnosis and treatment of disease.
2. Awareness of the importance of a physician’s own health behavior in fostering quality in his or her personal life and enabling the physician to function as a positive role model.
3. Recognition of the importance of both physician and patient working together as partners in promotion optimal health.
4. Encouraging the patient’s awareness of self-responsibility in obtaining optimal health.
5. Recognition of the importance of family structure and support systems in health behavior.
6. An understanding of and ability to work with the patient’s level of readiness to change and the problem of recidivism.
7. An emphasis on assessment of risks for preventable disease in each patient.
8. Recognition of the importance of updating practice behavior based on continuing review of the medical literature.

Knowledge of the following:

1. Categories of prevention
   1. Primary prevention: immunization, fluoridation, health promotion
   2. Secondary prevention: early diagnosis and treatment, such as Papanicolaou test, breast examination, blood pressure check-ups
   3. Tertiary: rehabilitation, such as poststroke physical therapy
2. Nutrition
   1. Fat/cholesterol
   2. Caloric balance
   3. Fiber
   4. Calcium
   5. Folic acid
   6. Special needs in pregnancy, children and older adults
   7. Five daily fruit and vegetable servings
   8. Food fads
   9. Obesity
   10. Vitamins, minerals, antioxidants
3. Exercise
   1. Types of exercise
      1. Aerobic versus anaerobic
      2. Isometric, isotonic, isokinetic
      3. Caloric expenditures per activity
      4. Metabolic energy equivalents (METS)
   2. Benefits
   3. Injury prevention
      1. Warm-up and cool-down
      2. Conditioning
      3. Strength, flexibility and balance
      4. Avoidance of overuse syndrome
4. Psychosocial well-being
   1. Internal perceptions
      1. Life goals
      2. Spiritual beliefs
      3. Self-esteem and efficacy
   2. External relationships
   3. Stress
      1. Recognition
      2. Management
   4. Life adjustment periods
      1. Significant life events (e.g., bereavement, divorce, illness)
      2. Life transitions (i.e., parenting, adolescence, early adulthood, mid-life aging)
5. Injury Prevention
   1. Motor vehicle accidents
   2. Household injury
   3. Recreational injuries, including protective equipment
   4. Interpersonal violence
6. Prevention of sexually transmitted infections and unintended pregnancy
7. Chemoprevention
   1. Aspirin
   2. Vitamin E
   3. Folic acid
   4. Hormone replacement therapy
   5. Sunscreens
   6. Fluoride
   7. Calcium
   8. Other
8. Environmental
   1. Occupational safety and health
   2. Housing
   3. Sanitation
   4. Toxic exposures such as air, water, waste sites, heavy metals
   5. Secondhand smoke
9. Individual and population characteristics for risk assessment
   1. Age and sex
   2. Family history including genetic, ethnic and behavioral
   3. Geographic and environment factors
   4. Socioeconomic status
   5. Lifestyle characteristics
10. Criteria for use of screening tests
    1. Incidence, prevalence and natural history of disease
    2. Treatment effectiveness
    3. Sensitivity
    4. Specificity
    5. Predictive value Patient acceptability
    6. Simplicity
    7. Cost effectiveness
11. Periodic health examination protocols, particularly those of the American Academy of Family Physicians and the U.S. Preventive Services Task Force
12. Prevention methodology

Skills in the Following:

1. Information gathering
   1. History
      1. Diet
      2. Alcohol, tobacco, drug use
      3. Exercise
      4. Stress
      5. Sleep
      6. Family
      7. Occupation
      8. Recreation
      9. Safety habits
      10. Health benefits
      11. Spiritual beliefs
      12. Patient awareness
      13. Motivation for lifestyle change
   2. Physical examination
      1. Fitness evaluation
      2. Body-fat content
2. Implementation
   1. Modeling a healthy lifestyle and self-responsibility
   2. Counseling skills
      1. Individual/family/group
      2. Behavior change
   3. Motivational techniques
   4. Stress management techniques
   5. Exercise prescription
   6. Nutrition prescription
   7. Sleep counseling
   8. Utilization of physician and patient reminder systems
   9. Utilization of community resources
      

1. Substance use disorders. Core educational guidelines for family practice residents. Reprint no. 277 Kansas City, MO. : AAFP, 1990.
2. Health People 2000,. http://odphp.osophs.dhhs.gov/pubs/hp2000/
3. Guide to clinical preventive services. Reports of the U.S. Preventive Services Task Force. http://www.usptf.gov
4. Age charts for periodic health examination. http://www.aafp.org
5. Botelho RJ, Skinner H. Motivating change in health behavior. Implications for health promotion and disease prevention, Prim Care 1995; 22:565-89.