Populations are aging, and unhealthy lifestyles and chronic
diseases are becoming more prevalent [1,2]. The rapid increase in
the prevalence of chronic illness has increased the demand for
health care services and constrained the organization and delivery
of chronic care [3–5]. Because health care systems have historically
been organized around acute care, many organizations are
struggling to improve the quality of chronic care delivery and
effectively manage the health behaviors of chronically ill patients
[6–13]. Health behaviors such as smoking and physical inactivity
are important risk factors for many chronic diseases and leading
causes of death and disability [14]. While little is known about how
to best improve health behaviors of chronically ill patients in the
primary care setting [15–19], we do know that effective and highquality
chronic care, including preventive health behavior interventions
that actively involve chronically ill patients and improve
their quality of life, is needed