将预防措施付诸实践。多方面医生教育项目对市中心区预防服务的影响。

Putting prevention into practice. Impact of a multifaceted physician education program on preventive services in the inner city.

作者信息

Gemson D H, Ashford A R, Dickey L L, Raymore S H, Roberts J W, Ehrlich M H, Foster B G, Ganz M L, Moon-Howard J, Field L S

机构信息

Harlem Center for Health Promotion and Disease Prevention, Columbia University School of Public Health, New York, NY, USA.

出版信息

Arch Intern Med. 1995 Nov 13;155(20):2210-6. doi: 10.1001/archinte.155.20.2210.

DOI:10.1001/archinte.155.20.2210

PMID:7487243

Abstract

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.

摘要

背景

医生的预防措施往往与国家权威机构发布的指南不同。在那些可预防疾病负担过重的市中心地区，对有效的预防服务需求最为迫切。本研究考察了一项多方面的医生预防教育项目对一家市中心市级医院预防服务提供情况的影响。

方法

该研究在两家市中心市级医院采用了对照干预比较设计，这两家医院分别是纽约州纽约市的哈莱姆医院中心（干预地点）和纽约州布鲁克林的国王郡医院（对照地点），主要服务非裔美国患者群体。干预地点从美国公共卫生服务局的“将预防付诸实践”运动中获得了针对医生、患者及办公环境的原型材料，并在1991年11月至1992年4月期间举办了一系列预防讲座。通过自我填写问卷评估医生预防措施和知识的变化，通过结构化访谈评估患者报告的所接受预防服务的变化。