State of Prevention in Allied Health Education and Practice, The

Journal of Allied Health, Fall 2004 by Sportsman, Susan, Hawley, Linda J, Bowles, Betty

PUT PREVENTION INTO PRACTICE

Given limited resources in health care, skeptics often question the effectiveness of prevention strategies, particularly because of the difficulty in integrating prevention into primary care practice. Nelson et al.10 evaluated state trends regarding achievement of Healthy People 2000 goals. States have made substantial and relatively uniform progress regarding adult immunization for influenza and pneumonia, screening mammography, and seatbelt use. The results for physical activity, tobacco use, binge drinking, and screening for elevated blood cholesterol levels vary substantially, however, among the states.

The unevenness with which prevention is a routine part of health care may be related to the difficulty in integrating health promotion/risk reduction into practice, even in primary care. The Put Prevention Into Practice (PPIP) Initiative was developed to facilitate this integration into primary care. The PPIP Initiative, currently sponsored by AHRQ, is a customizable, implementation program for preventive services derived from recommendations of the USPHSTF. Documentation of prevention services (Adult and Children's Health Risk Profiles, Preventive Care Charts and Flow Sheets, and Immunization Flow Sheets), educational handouts, and a process for implementing the PPIP concepts in a practice site are outlined in "A Step-byStep Guide to Delivering Clinical Preventives Services: A Systems Approach."7

Preparation of Professionals in Prevention

Critical to national implementation of prevention strategies are health care professionals who have necessary knowledge and skills in health promotion and risk reduction. This need was emphasized when the Pew Commission identified health promotion expertise for all health care professionals as a priority in academic and clinical training.11 Several years later, are these groups prepared to deliver preventive care? Is prevention included in the curricula of physicians, nurses, and allied health professionals, or do they learn these skills in ongoing continuing education courses or through on-the-job training?

Wilson et al.12 attempted to answer these questions by surveying 534 allied health program directors, representing 36 different disciplines throughout the United States. The program directors were queried to determine: (1) the extent to which health promotion/disease prevention content was represented in allied health program curricula, and (2) faculty perceptions regarding the importance of health promotion/disease prevention in the curriculum. Of the 41-2% of the program directors who responded to the survey, 27% reported that health promotion/disease prevention content was highly represented in allied health curricula, 37.6% reported moderate representation and 36.3% reported slight representation or none at all. Of the sample, 93.5% described health promotion/disease prevention as very or somewhat important to include in allied health education, primarily because it was important (1) to prepare students for the workplace and increase their knowledge and (2) to reflect changes in health care.