PubMed · 2924199
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M G Cavenar, C Luikart, J P Gogan. Compiling an information network.. https://pubmed.ncbi.nlm.nih.gov/2924199/
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BACKGROUND: Much effort has gone into producing clinical practice guidelines, but relatively few studies address dissemination issues. Unless guidelines are used, little is gained. This study evaluates the effect of three methods to disseminate asthma guidelines on physicians' behavior and attitudes toward education strategies. METHODS: Asthma guidelines were mailed to 60 physicians in three Area Health Education Centers in Arkansas. Dissemination efforts at one site featured a short summary, telephone calls by "detailing" physicians, and a continuing medical education conference. Computer strategies were used at the second site, and a multimedia approach with facsimile messages, posters, videocassettes, audiocassettes, and a continuing medical education conference was used at the third site. A fourth site with 22 participants served as a comparison. Data were collected by mailed questionnaires, outpatient chart reviews, and physician interviews. Changes between baseline and posttest assessments following a 4-month intervention were calculated for medication use, and peak flow monitoring use was compared with the control group (general linear model). Regression analyses were used to identify physician and practice factors associated with particular education techniques. RESULTS: Each site improved in the use of medications or peak flow monitoring, but none improved in all areas. The multimedia, continual reminder approach was well accepted but there was little support for the computer strategies. CONCLUSIONS: Further efforts to disseminate clinical guidelines should include a variety of formats with an emphasis on short, concise summaries and frequent reminders. Social influence appears to play a role and will be a fruitful area for further research.
In 1977, the Swedish National Board of Health and Welfare published guidelines for comprehensive care of patients with diabetes. The Stockholm County (1.6 million inhabitants) responded and opened a Diabetes Education and Training Centre, LUCD, in 1979. The goal was to reduce the impact of long-term complications. The centre should translate available knowledge about diabetes care into clinical practice, promoting a shift of patients and resources to the primary health care sector. Follow-up studies and new knowledge have changed the short-term training strategies; the long-term goal has remained unchanged. Current work is concentrated on training of staff, improving methods to support better patient learning, aiding organisational changes, and supporting large-scale interventions aimed at both patients, staff and the public. The patient can realize the goals. Knowledge and demands expressed by persons with diabetes are necessary for improvements of diabetes care. The skilled patient is also a guarantee for continuity of care. Regular follow-up of diabetes services was an important impetus for progressive change of short-term training strategies.
Nutrition education for physicians in the United State and Canada, remains an orphan discipline with no improvement or changes in the past decade. This status has led to the creation of regional nutrition centers and networks to develop nutrition education programs in health professional schools. The expanded network concept now covers geographic areas in the northeastern, southeastern, and middle United States, with plans to extend to the far West and to establish a national coordinating center or "network of networks." The barriers to progress in nutrition education must be overcome, and their conquest could form the basis for initiating new regional networks or a coordinating center. Strategies for nutrition networking are applicable to other disciplines and provide guidance for creating consortia to deal with the diminished need for medical and surgical subspecialties and play an important role in the training of generalist physicians.