Health Behaviors: Supporting Patients Beyond the Emergency

Key Takeaways for Health Behavior Determinants of Health:

• Health behaviors include personal habits and lifestyle choices that significantly influence health outcomes.
• These behaviors account for a major portion of preventable morbidity and mortality in the U.S.
• Community paramedics are uniquely positioned to observe, address, and support behavioral changes during home visits.
• Key behaviors include smoking, physical inactivity, poor diet, substance use, and medication non-adherence.
• Promoting healthy behavior change requires trust-building, motivational interviewing, and culturally competent care.

Introduction

While emergency responders are trained to act fast and stabilize crises, community paramedics have the opportunity to take a longer view of health. Many of the conditions we respond to repeatedly—like heart disease, diabetes, and respiratory issues—are directly tied to modifiable health behaviors. Smoking, poor diet, sedentary lifestyle, and medication noncompliance aren’t just personal choices—they’re public health priorities.

Community paramedicine programs give EMS professionals the time and setting to engage with patients, understand what drives their health choices, and support long-term behavior change. This article explores the most common health behaviors impacting patient outcomes and the role of community EMS in coaching, educating, and empowering patients.

What Are Health Behaviors?

The U.S. Department of Health and Human Services defines health behaviors as actions individuals take that affect their health, either positively or negatively (USDHHS, 2020). These include:

• Tobacco and nicotine use
• Alcohol and substance use
• Diet and nutrition
• Physical activity
• Sleep habits
• Medication adherence
• Seatbelt use and injury prevention behaviors

According to the CDC, behavioral risk factors contribute to nearly 40% of all deaths in the U.S. annually (Mokdad et al., 2004). That makes them more deadly than infectious disease and access issues combined.

Health Behaviors Commonly Encountered by Community Paramedics

1. Tobacco Use

• Often tied to COPD, heart disease, and stroke.
• Ask about smoking, vaping, and tobacco chewing.
• Refer to quitlines or local cessation programs.

2. Alcohol and Drug Use

• Community paramedics may encounter patients with alcohol-related injuries, withdrawal symptoms, or overdose risks.
• Use nonjudgmental questioning and offer referrals to detox or outpatient counseling.

3. Nutrition and Food Choices

• Poor diet contributes to obesity, diabetes, hypertension, and cancer.
• Look for signs of food insecurity and refer to community food assistance programs.

4. Physical Inactivity

• Many patients have mobility issues or lack safe places to exercise.
• Encourage realistic activity goals—like daily walking or chair exercises.

5. Medication Non-Adherence

• Missed doses lead to poor chronic disease control and avoidable hospitalizations.
• Explore cost, understanding, side effects, and routine as barriers.
• Offer pill organizers, education, or coordination with pharmacies.

Behavioral Change Strategies for Community EMS Providers

Changing health behavior isn’t as simple as giving advice. Community paramedics should use techniques rooted in behavioral science and patient-centered care.

1. Motivational Interviewing (MI)

• An evidence-based method to explore ambivalence and support change.
• Focus on open-ended questions, reflective listening, and affirmations.

“What would make you feel ready to cut back on smoking?”

2. Stages of Change Model

• Understand whether a patient is in precontemplation, contemplation, preparation, action, or maintenance.
• Tailor conversations accordingly—don’t push action when a patient isn’t ready.

3. Culturally Competent Care

• Respect beliefs, values, and barriers unique to each patient’s background.
• Consider health literacy and preferred communication styles.

Real-World Example

Patient: A 62-year-old male with frequent CHF exacerbations.

Findings: Noncompliant with fluid restrictions, takes meds inconsistently.

Behavioral Factors: He lives alone, eats frozen meals high in sodium, and has difficulty reading prescription labels.

Intervention: Community paramedic provides education, connects him to Meals on Wheels, and sets up daily med reminders.

Outcome: Fewer hospital admissions, improved medication compliance.

Collaborating with Other Professionals

Community paramedics should work alongside:

• Primary care providers for integrated care planning.
• Health coaches and dietitians for behavior change support.
• Mental health professionals when behavior is tied to trauma or depression.
• Pharmacists for med reconciliation and adherence support.

Conclusion

Health behaviors are modifiable risk factors that community paramedics can influence—sometimes more effectively than providers who only see patients in clinical settings. Through trust, consistent follow-up, and realistic goal setting, paramedics help patients turn intentions into actions.

When we help someone quit smoking, manage their diet, or take their meds consistently, we’re not just improving vitals—we’re changing lives.

References

Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. JAMA, 291(10), 1238–1245. https://doi.org/10.1001/jama.291.10.1238

U.S. Department of Health and Human Services (USDHHS). (2020). Health Behaviors and Risks. https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-behaviors Centers for Disease Control and Prevention. (2023). Behavioral Risk Factor Surveillance System. https://www.cdc.gov/brfss/index.html

Ready to Learn More?

Stay tuned for the next article in our Determinants of Health Series: “Physical Environment: Why Home Conditions Matter in EMS.“ 🚑