PPIP Designed for Various Settings
N
umerous private, medical, and academic organizations and government agencies have incorporated Put Prevention Into Practice (PPIP) materials into national, regional, and local prevention-oriented clinical and educational activities. Three ongoing projects emonstrate PPIP’s versatility.Texas Funds Primary Care Sites
In 1994, the Texas Department of Health (TDH) made improving the delivery of
preventive services a priority and established support systems throughout the State to
encourage the implementation of PPIP. With that action, Texas became the first State to
pilot the PPIP strategy within its own primary care sites. Since then, TDH has provided
startup funds to large and small primary care sites statewide, including several Family
Practice Residency Programs. In addition, specially trained registered nurses are
available to provide one-on-one instruction of the materials and in PPIP implementation.
A partner in the original development, TDH continues to use the PPIP materials and has developed companion pieces, including a 20-item comprehensive health risk assessment, a 10-item targeted risk assessment, and a self-administered risk assessment that is currently being piloted in a rural setting. TDH will use research from the University of Texas to customize the Personal Health Guide to focus on Texans’ specific health needs. For more information, contact Pam Mathison, R.N. (
pam.mathison@tdh.state.tx.us), or Patsy Harper, R.N. (patsy.harper@tdh.state.tx.us) or call (512)458-7534.STEP-UP Evaluates PPIP as Delivery Tool
Launched in 1997, STEP-UP (Study To Enhance Prevention by Under-standing Practice) is
a clinical trial through Case Western Reserve Uni-versity designed to evaluate a
preventive service delivery intervention that is tailored to the unique characteristics of
each practice. Nurse facilitators for STEP-UP use the PPIP tools as examples of items that
practices can use or modify to meet their own needs.
STEP-UP includes family practice physicians in 80 practices across Northeast Ohio, including urban, rural, and suburban areas, as well as areas with large Amish populations.STEP-UP includes small practices (solo physicians) and large groups of physicians (the largest has more than 10 physicians), as well as clinics.
STEP-UP nurse facilitators have made practice-specific modifications for flow sheets (typically adding or deleting a service not appropriate for a practice’s population) and the post-it notes (one has been created one for adults and adolescents and another for children). Similarly, unique chart alert stickers have been developed (e.g., family history of colon polyps).
Air Force Improves Patient Participation
The United States Air Force has been using PPIP materials since the original launch in
1994. In particular, Air Force medical staff use the waiting room poster, Adult and Child
Preventive Care timelines, and the pocket-sized Personal Health Guide and Child Health
Guide to stimulate discussions with clients about recommended prevention screenings. The
timeline posters are displayed in the examination room of every Family Practice Clinic.
This way, clients can easily review the screening recommendations and discuss with their
providers which screenings should be included as part of their current or future
appointments.
Air Force medical staff have found the Health Guides, both adult and child, to be excellent discussion tools for health educators as part of a client’s health risk assessment. The guides allow clients to actively participate in their own care by documenting the results of their screenings and future preventive care needs. The Air Force experience reinforces data that show many clients like the concept of a personalized guide. For more information about PPIP, contact Lynn Soban at the Agency for Health Care Policy and Research at (301) 594-1364, ext. 1379, or e-mail
lsoban@ahcpr.gov. Organizations wishing to reprint PPIP materials can contact Judy Wilcox at 301) 594-1364, ext. 1389, to obtain computer disks and photographic negatives. Information also is available on the World Wide Web at www.ahcpr.gov/ppip/.