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November 13, 1995

Putting Prevention Into Practice: Impact of a Multifaceted Physician Education Program on Preventive Services in the Inner City

Author Affiliations

From the Harlem Center for Health Promotion and Disease Prevention (Dr Gemson, Mr Ganz, and Ms Moon-Howard); Division of Sociomedical Sciences, Columbia University School of Public Health (Drs Gemson and Elinson, Mss Foster and Moon-Howard, and Mr Ganz), and the Department of Medicine, Harlem Hospital Center (Drs Ashford, Raymore, Roberts, Ehrlich, Bennett, and Francis and Ms Field), New York, NY; and Office of Disease Prevention and Health Promotion, US Public Health Service (Dr Dickey), Washington, DC. Dr Dickey is now with the University of California, San Francisco. Drs Raymore and Roberts are now with The Johns Hopkins School of Medicine, Baltimore, Md. Dr Ehrlich is now with the Montefiore Medical Center, Albert Einstein School of Medicine, New York.

Arch Intern Med. 1995;155(20):2210-2216. doi:10.1001/archinte.1995.00430200096013

Background:  Physicians' prevention practices often differ from guidelines published by national authorities. Effective preventive services are most needed in inner city settings that suffer disproportionately from preventable diseases. This study examined the impact of a multifaceted physician prevention education program on the provision of preventive services in an inner city municipal hospital.

Methods:  The study used a controlled intervention comparative design at two inner city municipal hospitals— Harlem Hospital Center, New York, NY (intervention site) and Kings County Hospital, Brooklyn, NY (comparison site)—serving predominantly African-American patient populations. The intervention site received prototype materials for physicians, patients, and the office setting from the US Public Health Service's Put Prevention Into Practice campaign and a series of prevention lectures from November 1991 through April 1992. Change in physician prevention practices and knowledge was assessed by self-administered questionnaires and change in patients' reports of preventive services received was assessed by structured interviews.

Results:  Physicians at Harlem Hospital Center reported a greater postintervention increase in prevention practices and demonstrated a greater increase in prevention knowledge in comparison with physicians at Kings County Hospital. Patients at Harlem Hospital Center reported receiving increased preventive services from physicians after the intervention, while patients at Kings County Hospital did not report any significant change in preventive services received.

Conclusions:  A multifaceted physician education program using prototype materials from the Put Prevention Into Practice campaign with prevention lectures significantly increased the prevention knowledge and practices reported by physicians and the preventive services reported received by patients at an inner city municipal hospital.(Arch Intern Med. 1995;155:2210-2216)