Dissemination and implementation of Put Prevention into Family Practice.
BACKGROUND
The Put Prevention into Practice (PPIP) program was developed and disseminated to address patient, clinician, and office barriers that result in less than optimal delivery of preventive services in the United States.


METHODS
To study the dissemination of PPIP by the American Academy of Family Physicians (AAFP), pre- and post-dissemination surveys of knowledge about PPIP and purchase order data were obtained from the AAFP. In addition, a mail questionnaire was sent to a random sample of purchasers to study their use of PPIP.


RESULTS
After two years of active promotion, 27% of AAFP members had heard about PPIP, and PPIP components were purchased by 2,004 individuals during its inital dissemination. Flow sheets, health guides, exam room wall charts, and the Clinician's Handbook of Preventive Services were the PPIP items most frequently purchased and used. Excluding the Clinician's Handbook of Preventive Services, 58% of purchasers used one or more parts of the kit with an average of less than four items used per purchaser.


CONCLUSIONS
Initial dissemination and implementation of PPIP among family physicians was limited; continued promotion will likely improve dissemination of PPIP. However, this study, and others suggest that the simple availability of a kit of materials is not sufficient to enhance the delivery of preventive services as envisioned by clinicians or policy makers. Additional strategies for dissemination and implementation of preventive services will be required, such as providing external consultation services to practices, incorporation of preventive services into HMO organizations, and training of residents in strategies for change in their future practices.
Medder
J
J
Department of Family Medicine, University of Nebraska Medical Center, Omaha 68198-3075, USA. jmedder@mail.unmc.edu
Susman
J L
JL
Gilbert
C
C
Crabtree
B F
BF
McIlvain
H E
HE
McVea
K
K
Davis
C M
CM
Hawver
M
M
D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005194:Family Practice / Q000458:organization & administration / Q000706:statistics & numerical data*; D005568:Forms and Records Control / Q000592:standards / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D017410:Practice Guidelines as Topic; D011314:Preventive Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D015397:Program Evaluation; D014481:United States