Table 1 Description of content of four role plays

• 55-year-old individual with a history of obesity (BMI 34), hypertension, and pre-diabetes. Doesn’t want to get the influenza vaccine. A few years ago when he got the vaccine he got sick with vomiting and diarrhea a few days later; attributes this illness to the vaccine.

• 35-year-old smoker (smoking x 20 years) who uses smoking to relieve stress. Not particularly concerned about health problems that might develop in the future.

• 40-year-old with good job and decent marriage. Doesn’t drink during the week but drinks heavily on the weekends, to the extent that most weekends are just a blur. Spouse drinks some but not as much as patient. Drinking hasn’t interfered with work, does not get aggressive when intoxicated, and hasn’t had any DUIs (even though acknowledges some driving after drinking). “Just having a good time” on weekends and doesn’t agree with doctor that this is a problem.

• 60-year-old with numerous chronic medical problems (Type II diabetes, hypertension, coronary artery disease, obesity) for which many medications are taken. Frustrated with the number of medications and doesn’t always take them. Tends to be sedentary and does not have a healthy diet in spite of encouragement to do so.