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Clinical Preventive Services

PPIP in Texas


Philip Huang, M.D., M.P.H., Chief, Bureau of Disease, Injury and Tobacco Prevention, Texas Department of Health, Austin, TX.

The Texas Department of Health tailored the Federal Put Prevention Into Practice (PPIP) program to make it work for the State of Texas. In Texas, funding is given to family practice residencies, community-based clinics, and local health departments that demonstrate a commitment to using PPIP materials to achieve a systems change in their clinical setting. The clinics are provided with free PPIP materials and funding to support additional staff or minimize the burden on existing staff.

The modifications were made because health department officials soon discovered that clinics needed assistance in initiating the process, developing their prevention products, and getting all healthcare workers involved. Based on experiences in Texas, PPIP officials recommend that clinics start with high-priority prevention items, such as immunizations and counseling to promote smoking cessation, thus easing into the program. Not all initiatives need to be addressed at once. Clinics should choose those they are most interested in and approach implementation incrementally.

Texas PPIP officials observed instances of resistance by public health professionals reluctant to change. In addition, they were told that addressing all of the PPIP topics could be overwhelming. Despite these concerns, Dr. Huang found that a true systems change is possible when promoting the entire PPIP package.

To be successful, clinics must:

  • Develop a PPIP office packet containing customizable material that can be broken down by topic.
  • Develop supplemental disease management guidelines and educational materials (such as diabetes).
  • Develop and use the implementation guide.
  • Increase partnerships with MCOs.
  • Promote the increased use of EMRs.


Frame PS. Developing office systems for preventive care. Preventive Medicine in Managed Care 2000;1(1):45-50.

Gemson DH, Dickey LI, Ganz ML, et al. Acceptance and use of Put Prevention Into Practice materials at an inner city hospital. Am J Prev Med 1996;12:233-7.

Goodson P, et al. Put Prevention Into Practice: Evaluation of program initiation in nine Texas clinical sites. Am J Prev Med 1999;17(1).

McGinnis JM. Actual causes of death in the U.S. JAMA 1993;18:2207-12.

Readiness to Put Prevention Into Your Practice. Bureau of Chronic Disease Prevention & Control, Texas Department of Health, the Department of Kinesiology and Health Education, University of Texas at Austin and the Texas Medical Association.

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