Medicina

The Scientific World Journal Volume 2012, Article ID 379752, 14 pages doi:10.1100/2012/379752

The cientificWorldJOURNAL

Research Article eVITAL: A Preliminary Taxonomy and Electronic Toolkit of Health-Related Habits and Lifestyle
´ Luis Salvador-Carulla,1, 2 Carolyn Olson Walsh,3 Federico Alonso,1, 2 Rafael Gomez,1 1 Jos´ Ricardo Cabo-Soler,1 Antonio Cano,1 and Menc´a Ruiz2 Carlos de Teresa,e ı
1 Asociaci´ n o

Espa˜ ola para el Estudio Cient´fico del Envejecimiento Saludable (AECES), Calle Infante Don Fernando 17, n ı M´ laga, 29200 Antequera, Spain a 2 Asociaci´ n Cient´fica PSICOST, Plaza de San Marcos 6, 11403 Jerez, Spain o ı 3 Harvard Medical School, c/o Peabody Society, 260 Longwood Avenue, Boston, MA 02115, USA Correspondence should be addressed to Luis Salvador-Carulla,luis.salvador@telefonica.net Received 14 October 2011; Accepted 28 November 2011 Academic Editor: Javier Garcia Campayo Copyright © 2012 Luis Salvador-Carulla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. To createa preliminary taxonomy and related toolkit of health-related habits (HrH) following a person-centered approach with a focus on primary care. Methods. From 2003–2009, a working group (n = 6 physicians) defined the knowledge base, created a framing document, and selected evaluation tools using an iterative process. Multidisciplinary focus groups (n = 29 health professionals) revised the document andevaluation protocol and participated in a feasibility study and review of the model based on a demonstration study with 11 adult volunteers in Antequera, Spain. Results. The preliminary taxonomy contains 6 domains of HrH and 1 domain of additional health descriptors, 3 subdomains, 43 dimensions, and 141 subdimensions. The evaluation tool was completed by the 11 volunteers. The eVITAL toolkitcontains history and examination items for 4 levels of engagement: self-assessment, basic primary care, extended primary care, and specialty care. There was positive feedback from the volunteers and experts, but concern about the length of the evaluation. Conclusions. We present the first taxonomy of HrH, which may aid the development of the new models of care such as the personal contextual factors ofthe International Classification of Functioning (ICF) and the positive and negative components of the multilevel person-centered integrative diagnosis model.

1. Introduction
Noncommunicable diseases cause 6 out of 10 deaths, and cardiovascular disease alone causes 31.5% of deaths in female and 26.8% in males [1]. Many of the leading causes of death have evidence-based modifiable risk factors[2–4], but this does not always translate to healthy behavior by individuals. Several studies have shown that risk of mortality or disease decreases stepwise based on the number of healthy habits practiced by an individual [5, 6]. In spite of the fact that major chronic diseases are caused by multiple risks, which when combined are associated with health outcomes, the science of multiple healthbehavior change and assessment is at an early stage, and factors that facilitate or impede success

in investigative or clinical intervention in multiple behavior change are unknown [7]. The developing field of longevity medicine takes a holistic view of health that calls for integrative evaluation of health-related habits (HrHs), both those that increase and decrease risk of disease and those relatedto general health and well-being, considering the endpoint of years lived without disability and taking into account a person-centered approach [8]. Taxonomies are particularly important in developing fields of study in that they standardize terminology and allow for common understanding of research results; recently proposed examples include the fields of adverse drug reactions [9] and...