AN OUNCE OF PREVENTION - EVALUATION OF THE PUT PREVENTION INTO PRACTICE PROGRAM

BACKGROUND. The ''Put Prevention into Practice'' (PPIP) program was de signed to enhance the capacity of health care providers to deliver cli nical preventive services. This study was designed to evaluate the pro gram's effectiveness when applied to family physicians in private prac tice settings. METHODS. Eight Midwestern practices that had purchased PPIP kits were identified and agreed to participate in the study. A co mparative case study approach encompassing a variety of data collectio n techniques was used. These techniques included participant observati on of clinic operations and patient encounters, semistructured and key informant interviews with physicians and staff members, chart reviews , and structured postpatient encounter and office environment checklis ts. Content analysis of the qualitative data and construction of the i ndividual cases were done by consensus of the research team. RESULTS. PPIP materials are not being used, even by the clinics that ordered th em. Physicians already providing quality preventive services prefer th eir existing materials to those in the PPIP kit. Sites that are underu tilizing preventive services are unable or unwilling to independently implement the PPIP program. CONCLUSIONS. Development of technical supp ort may facilitate implementation of PPIP materials into those practic es most deficient in providing preventive services. Given the diversit y of practice environments it is unlikely that a ''one size fits all'' approach will ever be able to address the needs of all providers.