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Related Experiment Videos

Promoting prevention services in primary care: a controlled trial.

M B Johns1, M F Hovell, C A Drastal

  • 1Division of Health Promotion, Graduate School of Public Health, San Diego State University, CA 92182.

American Journal of Preventive Medicine
|May 1, 1992
PubMed
Summary

An in-chart checklist intervention significantly increased health risk behavior discussion and counseling among primary care providers. However, it did not improve referrals or prescription of change for all patient groups.

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Area of Science:

  • Primary Care Medicine
  • Health Promotion
  • Behavioral Science

Background:

  • Low baseline rates of screening, counseling, and referral for 11 health risk behaviors in routine primary care visits.
  • Existing health promotion services are inconsistently provided by primary care physicians.

Purpose of the Study:

  • To assess the efficacy of an in-chart checklist intervention designed to increase screening, counseling, and referral for 11 risk behaviors.
  • To evaluate the impact of this intervention on different types of patient visits and provider practices.

Main Methods:

  • A two-group hybrid, multiple baseline and reversal design was employed.
  • Chart reviews of randomly selected patients were conducted before and during the intervention.
  • Follow-up interviews with providers were used to support findings and explore attitudes.

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Main Results:

  • Significant increases in the discussion and prescription of change for risk behaviors were observed during the intervention, though referrals did not increase.
  • Routine gynecologic care and birth control visits showed higher baseline levels and increased discussion of risk behaviors, but not prescription or referral.
  • Provider variability in response to the intervention was noted.

Conclusions:

  • The in-chart checklist intervention shows promise for increasing health promotion discussions but requires refinement to improve prescription and referral rates.
  • Provider attitudes towards health promotion and variability in intervention response highlight the need for tailored approaches.
  • Further development of interventions is necessary to enhance comprehensive health promotion services in primary care.