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Clinical Preventive Services

Put Prevention Into Practice


Hazel Keimowitz, M.A., Manager, Put Prevention Into Practice Program, Office of Health Care Information, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD.

Put Prevention Into Practice (PPIP) is an implementation program that is derived from the recommendations of the U.S. Preventive Services Task Force. The purpose of PPIP is to increase the appropriate use of preventive services in the clinical setting. PPIP accomplishes this by seeking to reduce barriers to the effective delivery of preventive care, such as the lack of an evidence-based framework.

A program such as PPIP is beneficial because an evidence base exists that shows that clinical preventive services can prevent some of the leading causes of death, such as heart disease and cancer. PPIP is based on research-tested interventions for improving delivery of preventive service in primary care settings and includes focus group testing with clinicians, office staff, and patients.

Ms. Keimowitz outlined the following barriers to delivering clinical preventive services:

Patient barriers:

  • Lack of knowledge.
  • Anxiety about procedures and results.
  • Inconvenience.
  • Costs.

Clinician barriers:

  • Lack of prevention training and knowledge.
  • Lack of confidence that prevention makes a difference.
  • Lack of time.
  • Inadequate reimbursement.

Office barriers:

  • Lack of knowledge.
  • Lack of motivation.
  • Unwillingness to change.
  • Lack of effective teamwork.
  • Inadequate systems for delivery.
  • Tracking and followup for preventive services.

PPIP implementation requires preparation, teamwork, and commitment. The readiness of the staff and the current level of delivery must be assessed before implementation can begin. Programs are most successful when one designated staff member leads the effort. This person should provide support and feedback to the whole team and create a feeling of ownership for those involved.

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