A clinical trial of tailored office systems for preventive service delivery
Abstract
Background The potential of primary care practice settings to prevent disease and morbidity through health habit counseling, screening for asymptomatic disease, and immunizations has been incompletely met. This study was designed to test a practice-tailored approach to increasing preventive service delivery with particular emphasis on health habit counseling.Design Group randomized clinical trial and multimethod process assessment.Setting/participants Seventy-seven community family practices in northeast Ohio.Intervention After a 1-day practice assessment, a nurse facilitator met with practice clinicians and staff and assisted them with choosing and implementing individualized tools and approaches aimed at increasing preventive service delivery.Main outcome measure Summary scores of the health habit counseling, screening and immunization services recommended by the U.S. Preventive Services Task Force up to date for consecutive patients during randomly selected chart review days.Results A significant increase (p=0.015) in global preventive service delivery rates at the 1-year follow-up was found in the intervention group (31% to 42%) compared to the control group (35% to 37%). Rates specifically for health habit counseling (p=0.007) and screening services (p=0.048) were increased, but not for immunizations.Conclusions An approach to increasing preventive service delivery that is individualized to meet particular practice needs can increase global preventive service delivery rates.
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The overall risk of bias for Goodwin 2001 was unclear (1 high risk, 4 unclear risk criteria).
“Risk of bias overall Unclear risk 1 high risk, 4 unclear risk criteria”
From Tailored interventions to address determinants of practice (2015) · cites this paper as Goodwin 2001
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- Authors
- Goodwin, M. A., Zyzanski, S. J., Zronek, S., Ruhe, M., Weyer, S. M., Konrad, N., Esola, D., & Stange, K. C.
- Affiliations
- Case Western Reserve University (US)
- University Hospitals of Cleveland (US)
- Corresponding author
- Goodwin, Meredith A
- ORCID
- Stange, Kurt C
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2001-07
- Volume
- 21
- Issue
- 1
- Pages
- 20-28
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2028346973
- Cited by
- 144
- References
- 102
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 4 · 2012: 8
- FWCI
- 8.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01CA060862, 2R01 CA 60862, K24 CA81931)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- disease screening, immunization, primary care practices, nurse facilitators, practice assessment, USPSTF recommendations, personalized interventions, general practice
- MeSH terms
- Adult, Counseling, Cross-Sectional Studies, Delivery of Health Care, Family Practice, Female, Health Services Research, Humans, Immunization, Male, Mass Screening, Office Visits, Ohio, Outcome and Process Assessment, Health Care, Practice Patterns, Physicians', Preventive Health Services, Primary Health Care, Program Evaluation, Multivariate Analysis, Practice Guidelines as Topic
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