The National DES Education Program: effectiveness of the California Health Provider Intervention.
BACKGROUND
Diethylstilbestrol (DES), a synthetic estrogen prescribed during pregnancy between 1938 and 1971, was later shown to have serious health effects, including higher risks of cancer in daughters and mothers. The authors report results of an intervention to increase health care providers' awareness of preventive care for women exposed to DES before birth.


METHODS
A controlled trial enrolled 20 to 25 health care providers in each of three communities to test the effectiveness of an academic detailing intervention. Outcomes (knowledge, routine screening) were assessed by provider questionnaires and patient surveys.


RESULTS
DES knowledge, familiarity with national guidelines, and screening for exposure increased significantly in the intervention communities but not in the control communities. The intervention effect for DES screening was significant (p = 0.01). Patient surveys confirmed provider self-report.


CONCLUSIONS
Academic detailing can increase DES knowledge and history taking among primary care providers. This intervention could be disseminated to increase knowledge of DES preventive care.
Cohn
Barbara A
BA
Center for Research on Women's and Children's Health, Public Health Institute, Berkeley, California 94709, USA. crwch@emf.net
Wingard
Deborah L
DL
Patterson
Rhiannon C
RC
McPhee
Stephen J
SJ
Gerbert
Barbara
B
D002140:California; D002273:Carcinogens / Q000009:adverse effects*; D003153:Community Health Services; D004054:Diethylstilbestrol / Q000009:adverse effects*; D004968:Estrogens, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D006293:Health Promotion; D006801:Humans; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015397:Program Evaluation; D014625:Vaginal Neoplasms / Q000139:chemically induced*
D002273:Carcinogens; D004968:Estrogens, Non-Steroidal; D004054:Diethylstilbestrol