To the Editor. —
In a recent article published in the December issue of the ARCHIVES, Belcher1 examines the effects of four types of health care practice (three interventions and usual care) on health promotion. The only effective practice was the intervention involving provision of a health promotion clinic. Belcher noted that the element of volunteerism of clinic patients, not present with the other interventions, was a key for success.There are other possible explanations for the difference found. One possibility relates to the care providers. An element in the health promotion clinic care that differs from the other practices, but which Belcher does not discuss, is that the health promotion clinic care was provided by a different type of health care professional. The health promotion clinic was held by nurse practitioners with physician referral, rather than physicians, as in the other three groups.It is not surprising that
baggs JG. Health Promotion and Nurses. Arch Intern Med. 1991;151(12):2484. doi:10.1001/archinte.1991.00400120112029
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