PubMed · 6902223
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P Slack. 1980-07-31. Bricks without mortar.. https://pubmed.ncbi.nlm.nih.gov/6902223/
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This paper examines the approach taken to health promotion and disease prevention in primary care in the UK, using coronary heart disease prevention (CHD) as an illustration. The paper considers the approach taken by the UK's government, the level of involvement of general practitioners (GP) and community nurses in CHD prevention, the factors that influence variation in involvement and the evidence for effectiveness.
Proactive health visiting refers to a model of health visiting practice which involves actively seeking and meeting the health needs of a defined community. In Fife a working group was established to draw up an operational definition of this concept. Training for health visitors was introduced on a patch-by-patch basis in Fife between December 1992 and May 1993 and an evaluation was subsequently carried out to assess whether or not the proactive concept was being implemented and practised throughout Fife. The survey results suggest that the proactive training has been successful in bringing about a change in health visitor practice over a relatively short time period. With an increasing amount of health visiting work taking place in clinic settings it will be important to define the relative roles of general practitioners, practice nurses and health visitors. A number of operational constraints were identified by the survey and these tended to limit the implementation of the proactive approach. However, we believe that the initiatives which have been successfully introduced should be encouraged and supported, and recommend that this approach be more widely adopted.