title: Impact of environmental patient education on preventive medicine practices.
abstract: BACKGROUND
  Studies show that provider-oriented reminders alone are less effective at increasing physician compliance with prevention guidelines than are combinations of patient- and provider-oriented physician reminders. The effectiveness of environmental patient education (ie, office-based videos, pamphlets, and posters) without individual staff or educator involvement has not been well established. The objective of this study was to evaluate the effectiveness of environmental patient education in increasing the amount of preventive services patients receive.
  
  
  METHODS
  A nonrandomized controlled trial using historical controls was conducted in a model family practice clinic at the University of New Mexico School of Medicine in Albuquerque. The study group (n = 389) included adult women who had been seen at the clinic at a time when educational materials were present in the waiting area. The control group (n = 381) were similarly selected patients seen during the same period of the previous year, when no such materials were available. During the intervention, patients in the waiting area were exposed to educational materials that encouraged them to ask their physicians about cholesterol testing, Papanicolaou (Pap) smears, tetanus boosters, and mammograms. For both the control and study groups, physician orders for preventive services were monitored over a 4-month follow-up period by reviewing medical records.
  
  
  RESULTS
  There were no statistically significant changes in the number of cholesterol tests, Pap smears, tetanus boosters, or mammograms ordered after the environmental patient education intervention, despite adequate statistical power.
  
  
  CONCLUSIONS
  Environmental patient education materials were not effective in increasing the amount of preventive services performed by physicians in this study. Although such interventions are inexpensive, easily comprehended, and well intended, they may be ineffective in increasing the performance of patient preventive services.
authors.affiliation: Department of Family and Community Medicine, University of New Mexico, Albuquerque 87131, USA.
authors.forename: V P
authors.initials: VP
authors.lastname: Mead
authors.forename: R L
authors.initials: RL
authors.lastname: Rhyne
authors.forename: W H
authors.initials: WH
authors.lastname: Wiese
authors.forename: L
authors.initials: L
authors.lastname: Lambert
authors.forename: B
authors.initials: B
authors.lastname: Skipper
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood; D003299:Cooperative Behavior; D005194:Family Practice; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test; D010353:Patient Education as Topic / Q000379:methods*; D010821:Physicians, Family / Q000523:psychology; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011322:Primary Prevention; D013745:Tetanus Toxoid; D014626:Vaginal Smears / Q000706:statistics & numerical data
chemical_list: D013745:Tetanus Toxoid; D002784:Cholesterol