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Results for “Preventive Health Services”

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At least 19 recordsLinked to original sources
PubMedDate not supplied

Community organization to enhance the delivery of preventive health services.

Preventive health services are most effective when provided to large groups, but health care professionals often are limited to provision to individuals or small groups. As recent studies show, the effects of preventive services can be enhanced through the use of community organization, which mobilizes a community's energies and resources to define and address a problem in a way that promotes local ownership and generates increasing effects over time. We pragmatically adapt community organization for health care practitioners. There are three guiding principles: (1) the community of interest must be clearly defined; (2) existing community structures should be used to reach and stimulate community members; and (3) the organizer's role is temporary. We discuss four tactics of community organization: (1) use of community analysis to understand the community; (2) stimulation of community activity; (3) provision of concrete assistance to accomplish community change; and (4) reinforcement of structures that will remain to carry on the programs. Use of these community organization tactics will allow delivery of preventive health services in a way that promotes widespread and lasting effects.

Community Health Services↗
PubMed1991

Utilization of preventive health services by an employed population.

To determine the utilization rates of selected preventive services in an employed population, we analyzed the responses of 18,053 health profile participants. Overall utilization rates for preventive services were high: 86.0% of respondents had their blood pressure checked, 94.0% of all women had a Pap smear and 81.3% had clinical breast examinations, 42.4% of respondents aged 40 and older had a rectal examination and 31.8% of those aged 50 and older had a test for occult blood in the stool, and 33.7% had a routine sigmoidoscopy. With the exception of blood pressure screening, the percentage of our respondents utilizing preventive services was considerably higher than the corresponding percentages in the US population as reported in the National Health Interview Survey. Nevertheless, the results suggest substantial opportunity for employers to encourage the appropriate use of preventive health services among employees.

Adult↗
PubMedDate not supplied

Identifying training needs in the public health workforce: the public health prevention service as a case study.

The Public Health Prevention Service is a three-year training program committed to developing a workforce that is skilled in planning, managing, and evaluating prevention programs. In 2000, a questionnaire was administered to participants to assess their training needs. According to the resultant data, training is preferred in traditional formats (e.g., case studies and group discussion) and in short installments (one to three hours). Topics identified for future training included software application, prevention effectiveness (i.e., economic analysis), program evaluation, budgeting, and consensus building.

Competency-Based Education↗
PubMedDate not supplied

The INSURE project on lifecycle preventive health services.

The INSURE Project on Lifecycle Preventive Health Services is a 3-year study to determine the feasibility of implementing preventive services in primary medical care as a health insurance benefit and to assess the short-term impact of this implementation on providers and consumers. Initiated by the life and health insurance companies, the project has received additional support from private philanthropic foundations. Preventive services, which will be provided under a lifecycle approach according to the age and sex of the patient and include education of patients on health-related behavior, will range from prenatal care through geriatrics. A quasi-experimental design will be used in which three study (experimental) group practice sites are matched with three control group practice sites. At the study sites, the primary care physicians will participate in orientation sessions on recommended preventive services and patient education procedure; they will also examine and counsel the study patients. The study and control physicians and patients will be surveyed before and after the program of intervention is conducted at the study sites to assess their knowledge, attitudes, and behavior toward health behavior practices.

Adult↗
PubMed1984

Prevention and health promotion in primary care: baseline results on physicians from the INSURE Project on Lifecycle Preventive Health Services.

The INSURE Project on Lifecycle Preventive Health Services is a 3-year feasibility study to develop and test a clinical model of preventive health services, including patient education, in primary medical care as an insurance benefit. Seventy-four primary care physicians in group practices were surveyed regarding their baseline attitudes toward, and practice of, preventive services. Physicians report that they tend to be conscientious in educating their patients about their health risks, although they spend little time in patient education. Physicians are not sanguine about their success in getting their patients to follow their recommendations and tend to harbor doubts about their own efficacy in these areas. Specialty differences exist in these parameters. Physicians evidence contradictory attitudes about prevention. They believe doctors should spend more time providing preventive services but also believe that the lack of insurance reimbursement is an obstacle to providing these services. The concept of structural or sociological ambivalence is advanced to explain this pattern.

Adult↗
PubMed1981

The use and non-use of preventive health services in a southern African village.

This study investigates the relationship between the health beliefs of mothers in a Botswana village and their utilization of available maternal and child health resources, specifically immunizations, antenatal care, and clinic delivery. The two-pronged methodology includes (1) a household survey of 620 mothers of children under the age of five and (2) a series of intensive but informal, loosely structured interviews with 19 village women. Results show that a majority of the children had received one immunization but that few had ever had more. Most of their mothers had attended the antenatal clinic, but fewer than 30% had made use of the village maternity service in childbirth. As predictors of these kinds of preventive behaviour, mother's age, education, use of the radio, participation in voluntary women's organizations, and material consumption were, for the most part, unimpressive. On the other hand, qualitative data from the survey and intensive interviews revealed that women were confused between curative and preventive health measures. Few respondents linked immunization with prevention of specific diseases; half the women expressed concern that the immunizations were dangerous, while others indicated lack of knowledge about the desired number; still others believed that immunizations "made the children grow". As for maternity services, the majority of women who attended the antenatal clinic had actually done so for a somatic complaint. They were responding to their perception of the clinic as a place that cures, rather than prevents, illness. This was consistent with the finding that few used the clinic delivery service: most women saw no reason to seek professional help in the absence of perceived problems. The authors point out implications of this study for community-centred, in contrast to disease-centred, health education.

Attitude to Health↗
PubMed2004

Relationships between level of disability and receipt of preventive health services.

OBJECTIVES: To examine relationships between level of disability and receipt of certain preventive health services, including demographic and systems variables that may explain or confound these relationships. DESIGN: Analysis of recent (1998 and 2000) data from the Behavioral Risk Factor Surveillance System, a nationwide telephone survey. SETTING: States reporting data on disability (13 in 1998, 18 in 2000). PARTICIPANTS: Noninstitutionalized persons living in the community. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Frequency of receipt of recommended preventive health services, including colorectal, cervical, and breast cancer screening, and influenza and pneumococcal vaccination. An ordinal index of disability severity was constructed from questions on activity limitations. RESULTS: In 2000, people with mild and moderate disability received influenza and pneumonia vaccinations somewhat more frequently than people without disabilities, but people with the most severe disabilities least frequently received vaccinations that year. Disabled women received fewer Papanicolaou tests and clinical breast examinations, but significant differences did not occur for mammograms in 2000. Fewer differences as a function of disability level were apparent in 2000 than 1998. Demographic variables affected receipt of most preventive services. Access to routine checkups affected all preventive services independent of disability level in both years. CONCLUSIONS: Severity of disability is related to receipt of certain preventive services but not necessarily in a simple or unidirectional way. Regardless of disability, receipt of a checkup was an important determinant of receipt of preventive health services. For almost all services and groups studied, preventive care remained below targeted goals for Healthy People 2010.

Persons with Disabilities↗
PubMed1996

Do preventive health services reduce eventual demand for medical care?

The aim of this study was to find out whether there is any relation between the use of preventive health services provided for by municipalities under the Japanese Health Services for the Elderly Act and the demands for in-patient and out-patient care by insured residents aged 40 or older who were covered by the National Health Insurance, eligible for preventive health services under the act, in nine cities within the same catchment area in Osaka Prefecture. Main outcome measures were correlation coefficients between the use of in-patient and out-patient care, and (1) the rate of use of health check-ups, and (2) the cost for preventive health services per resident. Hospital admission rate per 1000 insured persons had a strong negative correlation with the rate of use of health check-ups. The rate of long stay, 180 days or more, per 1000 insured persons was also negatively correlated with the rate of use of health check-ups. There were negative correlations between the rate of use of health check-ups and both the in-patient cost per insured person, and the rate of high in-patient cost, 600,000 Yen or more, per 1000 insured persons. On the other hand, out-patient utilization rate per 1000 insured persons had a positive correlation with the rate of use of health check-ups. However, there was a negative relation between the rate of use of health check-ups and the out-patient cost per insured person because of negative associations between the rate of use of health check-ups and the out-patient days, and cost per case. The rate of high out-patient cost, 60,000 Yen or more, was negatively correlated with out-patient utilization rate per 1000 insured persons. Negative relations were also shown between the cost for preventive health services per resident and the in-patient and out-patient cost per case and per insured person, except out-patient utilization rate per 1000 insured persons. The correlation coefficient between the cost for preventive health services per resident and the total medical cost per insured person was r = -0.779 (P = 0.007). Provision of preventive health services under the Health Services for the Elderly Act may possibly improve health management in the early stage of diseases by detecting abnormalities in health, and that investing in prevention might contribute to reducing the subsequent total demand for medical care.

Adult↗
PubMed1983

The INSURE Project on Lifecycle Preventive Health Services: cost containment issues.

The INSURE Project on Lifecycle Preventive Health Services (LPHS) is a three-year feasibility study to determine whether preventive health services can be implemented in the primary medical care setting as a covered health insurance benefit and what the short-term behavioral effects will be on physicians and their patients. Thus far, the negotiated reasonable and customary fees that have been paid are lower than anticipated. Patients have expressed a willingness to pay extra for preventive care insurance coverage if it were available. The positive reactions of providers and consumers and the reasonable cost of LPHS may prove to be more crucial than broader cost containment issues in determining the extent of health insurance coverage for preventive care in the future.

Cost Control↗
PubMedDate not supplied

Improving preventive health services training in chiropractic colleges: a pilot impact evaluation of the introduction of a model public health curriculum.

OBJECTIVE: To investigate the impact of the dissemination of the model public curriculum at one US chiropractic college on chiropractic interns during their outpatient clinical internship. METHODS: A retrospective pilot study was performed to evaluate the frequency of 9 patient clinical preventive health recommendations made by interns during their clinical training. The frequency of recommendations by interns completing their public health coursework after dissemination of the model curriculum was compared with those completing their coursework during the period immediately proceeding dissemination. A standardized data abstraction tool was developed to collect data from clinic charts that established a patient's need for any one of 9 preventive health services. RESULTS: Of the 408 charts examined (204 from each group), there were only 4 documented instances (1%) of recommendations for any of the 9 preventive health service categories. Two recommendations occurred in the precurriculum change period. CONCLUSION: The results of this pilot study indicate that there has been no observable impact on intern behaviors toward educating patients in preventive health services since the dissemination of the model public health curriculum at one of the chiropractic colleges in the United States. The impact of this reform in public health education may have been limited by its minimal focus on clinical preventive services and by a focus on didactic rather than a clinically relevant learning exposure.

Adult↗
PubMed2006

Perceived discrimination and use of preventive health services.

BACKGROUND: Little is known about the relation between perceptions of health care discrimination and use of health services. OBJECTIVES: To determine the prevalence of perceived discrimination in health care, its association with use of preventive services, and the contribution of perceived discrimination to disparities in these services by race/ethnicity, gender, and insurance status. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of 54,968 respondents to the 2001 California Health Interview Survey. MEASUREMENTS: Subjects were asked about experience with discrimination in receiving health care and use of 6 preventive health services, all within the previous 12 months. METHODS: We used multivariate logistic regression with propensity-score methods to examine the adjusted relationship between perceived discrimination and receipt of preventive care. RESULTS: Discrimination was reported by 4.7% of respondents, and among these respondents the most commonly reported reasons were related to type of insurance (27.6%), race or ethnicity (13.7%), and income (6.7%). In adjusted analyses, persons who reported discrimination were less likely to receive 4 preventive services (cholesterol testing for cardiovascular disease, hemoglobin A1c testing and eye exams for diabetes, and flu shots), but not 2 other services (aspirin for cardiovascular disease, prostate specific antigen testing). Adjusting for perceived discrimination did not significantly change the relative likelihood of receipt of preventive care by race/ethnicity, gender, and insurance status. CONCLUSIONS: Persons who report discrimination may be less likely to receive some preventive health services. However, perceived discrimination is unlikely to account for a large portion of observed disparities in receipt of preventive care.

Adult↗
PubMed1981

Mode of payment as a predictor of health status, use of health services and preventive health behavior: a report from the Los Angeles Health Survey.

Several issues relevant to Health Maintenance Organizations (HMOs) were examined in this article using data collected from the Los Angeles Health Survey. No support was found for the hypothesis that HMOs disproportionately attract people in poorer health. In fact, HMO members actually reported lower rates of acute or occasional illness and disability than fee-for-service subscribers (FFS). HMO members also reported lower total family incomes and educational status than FFS subscribers and they were less likely to report having a regular doctor. Few differences were found between the two groups in reports of using health services and practicing preventive health behavior. However, HMO members were more likely to report a recent physical examination--but only after taking into account the fact that they were less likely to have a regular doctor. It has been shown that these findings are consistent with recent evidence, and serve to amplify serveral key findings reported in other studies.

Adolescent↗