Periodic health encounter/preventive health advice

Rationale

A periodic health encounter or preventive health advice is an opportunity to detect health-related problems early or prevent them. The nature of the encounter will vary in timing and frequency, depending on the age, sex, occupation, and psychosocial background of the patient. The encounter may take the form of an in-person visit or virtual care and may include delegated acts by other health care team members.

Causal conditions

(list not exhaustive)

1. All ages
   1. Injury prevention (e.g., noise control, seat belts, bicycle helmets)
   2. Lifestyle modification (e.g., physical activity, smoking prevention or cessation, alcohol use, substance use, sun exposure)
   3. Immunization (see Immunization — 74-2)
   4. Review and/or screen for social determinants of health
   5. Mental health
2. Infant and child
   1. Nutrition
   2. Growth
   3. Development
   4. Behaviours
   5. Other (e.g., hearing, amblyopia)
3. Adolescence
   1. Sexual activity (e.g., contraception, sexually transmitted infection [STI] screening)
4. Young adult
   1. Reproductive health (e.g., Papanicolaou test, STI screening, folic acid)
5. Middle-aged adult
   1. Cardiovascular health risks (e.g., blood glucose, blood pressure, lipid profile)
   2. Cancer screening (e.g., breast, colon, prostate, skin)
   3. Osteoporosis
6. Older adult
   1. Fracture and fall prevention (e.g., osteoporosis screening)
   2. Nutrition
   3. Dementia screening

Key Objectives

Given a patient presenting for a periodic health encounter or an indication for preventive health advice, the candidate will assess age- and sex-specific risk factors to guide the history, physical examination, screening investigations, and counselling.

Enabling Objectives

Given a patient presenting for a periodic health encounter or an indication for preventive health advice, the candidate will

1. perform an appropriate history and physical examination based on the patient’s age, sex, and background;
2. list appropriate investigations and interpret the results of the investigations, including
   1. evidence-based screening investigations specific to age and sex (e.g., fasting glucose, mammography) while incorporating shared decision-making (e.g., discussing risk and benefits of screening);
3. construct an effective initial management plan, including
   1. communicating effectively with the patient to reach a common ground regarding goals related to disease prevention and risk reduction,
   2. recommending proven prevention strategies (e.g., smoking cessation, regular exercise), and
   3. incorporating preventive health principles into the care of the patient.