Although the concept of preventive services is supported by most healthcare providers, integration of comprehensive preventive care as part of regular clinical practice has been difficult. We hypothesize that flaws in medical theory are at root. Specifically, physician theory emphasizes practitioner independence. In contrast, nursing theory emphasizes greater uniformity; this is manifested, in part, by adherence to a single standard of nursing practice within any particular organization. We have started a three year, randomized, controlled trial of a new method for integrating preventive services that is based on nursing theory and a public health model. At a clinic that serves predominantly Medicaid patients, we have started enrollment planned for 890 participants on the Family Practice, Internal Medicine, and Pediatrics services. All participants are receiving an assessment that includes all A and B recommendations of the U.S. Preventive Services Task Force. Physicians in the practice have been randomized to either a usual care (physician) group or an intervention (nurse) group. Preventive medicine physicians provide back-up, both in terms of technical expertise and operation of clinics where persons needing more intensive service (e.g. smoking cessation) are seen. Outcomes will include the frequency with which preventive services are delivered in the usual care and intervention groups. Additional information pertaining to potential confounders and co-factors is also being obtained. Data from the first wave of information-gathering, to include initial comparative results, will be presented.
Learning Objectives: Attendees will be able to describe the initial results of a controlled trial designed to test a new model for preventive services integration and to discuss the implications of the findings.
Keywords: Prevention, Health Care Delivery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Meharry Medical College
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an employee of Meharry Medical College, and the study is being conducted at Meharry.