title: Put prevention into practice. Evaluation of program initiation in nine Texas clinical sites.
abstract: BACKGROUND
  Put Prevention Into Practice (PPIP) is a program designed to improve the delivery of clinical preventive services by primary care providers, through the use of specific office materials for providers and clinic staff, as well as an educational booklet for patients. The purpose of this study was to identify potential predictors of successful initiation of PPIP among 9 Texas public health clinics participating in a demonstration project funded by the Texas Department of Health (TDH).
  
  
  METHODS
  The PRECEDE model was utilized as a theoretical framework for the study. A qualitative, case study methodology was employed, with structured interviews and open-ended questions asked of each site's PPIP personnel. Information from the sites' report to the TDH on the number of charts containing PPIP forms was also used for purposes of data triangulation.
  
  
  RESULTS
  Sites that initiated PPIP successfully were characterized by a medium patient load, the ability to serve low-resource populations, prior attempts to implement categorical programs, existence of a philosophy of prevention, and pre-implementation planning. Barriers to successful initiation were identified as systems-related, patient-related, and staff-related.
  
  
  CONCLUSIONS
  We identified factors that might predict the successful initiation of PPIP in public health primary care settings. Implications of present findings for implementation of similar health promotion programs in clinical settings are discussed.
authors.affiliation: Division of Education, University of Texas at San Antonio 78249-0654, USA. pgoodson@stic.net
authors.forename: P
authors.initials: P
authors.lastname: Goodson
authors.forename: N H
authors.initials: NH
authors.lastname: Gottlieb
authors.forename: M M
authors.initials: MM
authors.lastname: Smith
mesh_terms: D001291:Attitude of Health Personnel; D003625:Data Collection; D006801:Humans; D008962:Models, Theoretical; D010349:Patient Compliance; D011314:Preventive Health Services; D011315:Preventive Medicine; D011320:Primary Health Care / Q000379:methods*; D015397:Program Evaluation; D013781:Texas