Physician perceptions of primary prevention: qualitative base for the conceptual shaping of a practice intervention tool.

Full Abstract

BACKGROUND:
A practice intervention must have its basis in an understanding of the physician and practice to secure its benefit and relevancy. We used a formative process to characterize primary care physician attitudes, needs, and practice obstacles regarding primary prevention. The characterization will provide the conceptual framework for the development of a practice tool to facilitate routine delivery of primary preventive care.

METHODS:
A focus group of primary care physician Opinion Leaders was audio-taped, transcribed, and qualitatively analyzed to identify emergent themes that described physicians' perceptions of prevention in daily practice.

RESULTS:
The conceptual worth of primary prevention, including behavioral counseling, was high, but its practice was significantly countered by the predominant clinical emphasis on and rewards for secondary care. In addition, lack of health behavior training, perceived low self-efficacy, and patient resistance to change were key deterrents to primary prevention delivery. Also, the preventive focus in primary care is not on cancer, but on predominant chronic nonmalignant conditions.

CONCLUSIONS:
The success of the future practice tool will be largely dependent on its ability to "fit" primary prevention into the clinical culture of diagnoses and treatment sustained by physicians, patients, and payers. The tool's message output must be formatted to facilitate physician delivery of patient-tailored behavioral counseling in an accurate, confident, and efficacious manner. Also, the tool's health behavior messages should be behavior-specific, not disease-specific, to draw on shared risk behaviors of numerous diseases and increase the likelihood of perceived salience and utility of the tool in primary care.

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Author information

Author/s: Mirand, Amy L (AL); Beehler, Gregory P (GP); Kuo, Christina L (CL); Mahoney, Martin C (MC);

Affiliation: Department of Cancer Prevention, Epidemiology, & Biostatistics, Roswell Park Cancer Institute, Buffalo, New York, USA. amy.mirand(-atsign-)roswellpark.org

Grants: CA90154-02 (Agency:NCI NIH HHS) ; P30 CA16056 (Agency:NCI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.

Journal: BMC public health (BMC Public Health), published in England. (Language: eng)

Reference: 2002-Aug; vol 2 (issue ) : pp 16

Dates: Created 2002/11/19; Completed 2002/11/26; Revised 2008/11/20;

PMID: 12204096, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Attitude of Health Personnel
Counseling
Decision Support Systems, Clinical
Family Practice
Focus Groups
Humans
Internal Medicine
New York
Patient Acceptance of Health Care - psychology

Patient Acceptance of Health Care - psychology
Physicians, Family - psychology
Primary Health Care - methods
Primary Prevention - methods
Qualitative Research
Risk Reduction Behavior
Self Efficacy
Social Marketing
Tape Recording

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