Prevention in primary care: variability in physician practice patterns in New York City.

A survey of physicians' attitudes and practices related to exercise promotion.

We conducted a telephone survey of a probability sample of 473 internists, family practitioners, general practitioners, and obstetrician-gynecologists in New York City (NY) in 1988 to assess their knowledge, attitudes, and practices with respect to the prevention of the acquired immunodeficiency syndrome (AIDS). Although 71% of the physicians had cared for a patient with AIDS and 90% had been involved in ordering the human immunodeficiency virus antibody test, only about a third of them took appropriate sexual histories of new patients and only about a quarter (28%) counseled new patients about reducing the risk of contracting AIDS. Multivariate analysis revealed that physician knowledge about AIDS prevention was associated with younger age, more positive attitude toward homosexual males and intravenous drug users, confidence that counseling would result in behavioral change among patients, and specialty other than obstetrics-gynecology. Results indicate a need for increased training and education of primary care physicians about AIDS prevention. ( Arch Intern Med . 1991;151:1102-1108)

Acquired immunodeficiency syndrome prevention : knowledge, attitudes, and practices of primary care physicians

Nurses' smoking worldwide. A review of 73 surveys on nurses' tobacco consumption in 21 countries in the period 1959-1988.

Impressive evidence supports the value of clinical preventive medicine, defined as the maintenance and promotion of health and the reduction of risk factors that result in injury and disease. Primary prevention activities deter the occurrence of a disease or adverse event, eg, smoking cessation. Secondary prevention (screening) is early detection of a disease or condition in an asymptomatic stage so treatment delays or blocks occurrence of symptoms, eg, mammographic detection of breast cancer. Tertiary prevention attempts to not allow adverse consequences of existing clinical disease, eg, cardiac rehabilitation to prevent the recurrence of a myocardial infarction. Preventive services have decreased morbidity and mortality from both acute and chronic conditions. However, these services are underutilized for numerous reasons. Barriers to their use include physician, patient, and health system factors. The traditional disease/treatment model should be modified to incorporate more preventive services. The subsequent 2 parts of this review will discuss suggestions for integrating primary preventive services and screening into primary care practice.

Clinical Preventive Medicine in Primary Care: Background and Practice: 1. Rationale and Current Preventive Practices

Preventive health care has been identified as a major function of the family physician. The ability of the family physician to significantly affect the preventive health status of a patient and his/her family is largely dependent on the preventive health attitudes and health care practices of the patient. This preliminary study identifies some of the attitudes towards preventive health and reported health care practices of a sample of patients in a model family practice unit. The authors found that social position was significantly associated with assessment of personal health, attitudes towards preventive health practices, and attitudes toward the preventive function of the physician. While the majority of the study population was willing to spend time to obtain preventive health care services, the same population was almost evenly divided about their willingness to spend extra money to obtain these services. The physician was cited as the most frequent source of health care information by respondents in this study.

A study of preventive health attitudes and behaviors in a family practice setting.

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A study of preventive health attitudes and behaviors in a family practice setting.