Remington R D
Department of Preventive Medicine, University of Iowa, Iowa City 52242.
Prev Med. 1990 Jan;19(1):105-13. doi: 10.1016/0091-7435(90)90013-a.
Characteristics of the relationship of preventive policy to preventive practice are reviewed. The relatively low emphasis on prevention compared with treatment programs is discussed and the particular problem of the "anonymity" of prevention is defined. Prevention programs suffer in part because of the lack of identity of the specific individuals benefited. Examples from the cardiovascular diseases are used to illustrate the general points. The contrast between community- and patient-oriented prevention is important. Adequate levels of disease prevention and health promotion will never be attained one case at a time. Interactions among individuals are determinants of environmental behavioral factors relevant to health. The policy forming process is intrinsically interactive in nature. The Institute of Medicine's 1988 study of the future of public health is reviewed with respect to its emphasis on professional participation in the health policy process. Prevention is an essentially multidisciplinary area requiring the participation of many professions and disciplines. This property of prevention will be enhanced in the future. Ten principles which can be useful in translating preventive policy into preventive practice are presented.
本文回顾了预防政策与预防实践之间关系的特点。讨论了与治疗项目相比，预防工作相对较低的重视程度，并明确了预防工作“匿名性”这一特殊问题。预防项目部分受阻的原因是受益的具体个体缺乏明确身份。以心血管疾病为例来说明这些要点。社区导向型预防和患者导向型预防之间的对比很重要。一次处理一个病例永远无法实现足够水平的疾病预防和健康促进。个体之间的相互作用是与健康相关的环境行为因素的决定因素。政策形成过程本质上是互动的。回顾了医学研究所1988年关于公共卫生未来的研究，该研究强调了专业人员参与健康政策制定过程。预防本质上是一个多学科领域，需要许多专业和学科的参与。预防工作的这一特性在未来将得到加强。本文提出了十条有助于将预防政策转化为预防实践的原则。
