US Preventive Services Task Force recommends behavioral counseling to prevent cardiovascular disease

Psychologists are specifically recognized as referral sources for the first time.

On Aug. 26, the U.S. Preventive Services Task Force (USPSTF) released an updated recommendation on dietary counseling for adults with cardiovascular risk factors. Unlike previous recommendations on cardiovascular risk factors and other health care topics, these recommendations specifically suggest referring patients to appropriately trained professionals including psychologists, dieticians or nutritionists, health educators, physiotherapists, exercise professionals or other trained professionals outside the primary care setting. 

The APA Practice Organization has sent letters in the past to the USPSTF advocating for the inclusion of psychological services in other recommendation statements, such as tobacco cessation. Though USPSTF recommendation statements are not mandates, the endorsement of referrals and the specific recognition of psychologists in this latest recommendation could help open the door to greater collaboration between primary care providers and mental and behavioral health professionals. 

The USPSTF recommends offering or referring adults who are overweight or obese (with body mass index scores of 30 or higher) and have at least one additional cardiovascular disease (CVD) risk factor to intensive, multicomponent behavioral counseling interventions for weight loss. Evidence shows that these interventions to improve diet and increase physical activity can help reduce risk for cardiovascular disease in adults who are overweight or obese and have high blood pressure, high cholesterol or high blood sugar.

Reflecting a systematic review of 74 healthy lifestyle counseling trials in persons with cardiovascular risk factors, the USPSTF noted that interventions were often delivered by specially trained professionals including psychologists, dieticians, nutritionists and health educators. 

The USPSTF is an independent panel composed of primary care providers — such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses and health behavior specialists — that focuses on prevention and evidence-based medicine. The USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services (such as screening, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. Task force recommendations are published in the form of "Recommendation Statements."