Clinical Prevention

  • Evan W. Kligman
  • Frank A. Hale


Clinical prevention is the connecting link between public health and primary care. Health education and health promotion counseling skills are among the most important tools in the family physician’s medical bag. A major challenge facing the family physician is how to bridge the gap between clinical prevention knowledge and practice, recognizing the impact of personal behaviors on health. The traditional biomedical approach to the diagnosis and treatment of disease is only a partial response to addressing the health care needs of patients. Patient care must encompass a prospective preventive approach toward helping individuals and families assume major responsibility for their own health-related behaviors.1,2


Family Physician Preventive Service Multiple Sexual Partner Preventive Service Task Intravenous Drug User 
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  1. 1.
    Kligman EW, Kamerow DB, Artz LM. Year 2000 health objectives and the family physician. Am Fam Physician 1990;42:851–41.PubMedGoogle Scholar
  2. 2.
    Pew Health Professions Commission. Healthy America: practitioners for 2005, an agenda for action for US health professional schools. In: Shugars DA, O’Neil EH, Baden JD, editors. Durham, NC: The Pew Health Profession, 1991.Google Scholar
  3. 3.
    Pommerenke FA, Dietrich A. Improving and maintaining preventive services. Part1. Applying the patient model. J Fam Pract 1992;34:86–91.PubMedGoogle Scholar
  4. 4.
    Richards JW, Blum A. Health promotion. In: Taylor R, editor. Family Medicine: Principles and Practice. 2nd ed. New York: Springer-Verlag, 1988.Google Scholar
  5. 5.
    Pommerenke FA, Dietrich AD. Improving and maintaining preventive services. Part2. Practical principles for primary care. J Fam Pract 1992;34:92–97.PubMedGoogle Scholar
  6. 6.
    US Preventive Services Task Force. Guide to clinical preventive services: an assessment of the effectiveness of 169 interventions. Baltimore: Williams & Wilkins, 1989.Google Scholar
  7. 7.
    Canadian Task Force on the Periodic Health Examination. The periodic health examination. Can Med Assoc J 1979; 121:1194–254.Google Scholar
  8. 8.
    American Cancer Society. Report on the cancer-related health checkup. CA 1980;30:194–240.Google Scholar
  9. 9.
    Frame PS. A critical review of adult health maintenance. Part 4. Prevention of metabolic, behavioral, and miscellaneous conditions. J Fam Pract 1986;23:29–39 (erratum: J Fam Pract 1986;23: 537).PubMedGoogle Scholar
  10. 10.
    Healthy people: the Surgeon General’s report on health promotion and disease prevention. Washington, DC: Government Printing Office, 1979; DHEW publication No. (PHS) 79–55071.Google Scholar
  11. 11.
    Woolf SH. Practice guidelines: a new reality to medicine. Arch Intern Med 1990;150:1811–18.PubMedCrossRefGoogle Scholar
  12. 12.
    Kamerow DB, Mickalide AD, Woolf SH. Preventive services in the office. HELP newsletter 1989;3:1–4 (American Academy of Family Physicians, Kansas City, MO).Google Scholar
  13. 13.
    Department of Health and Human Services. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives. Conference edition. Washington, DC: Department of Health and Human Services, 1990.Google Scholar
  14. 14.
    Borkan JM, Neher JO. A developmental model of ethnosensitivity in family practice training. Fam Med 1991;23:212–17.PubMedGoogle Scholar
  15. 15.
    AAFP Subcommittee on Periodic Health Intervention. Age charts for periodic health examination. Reprint No. 510. Kansas City, MO: American Academy of Family Physicians.Google Scholar
  16. 16.
    Zimmerman RK, Giebink GS. Childhood immunizations: a practical approach for clinicans. Am Fam Physician 1992;45:1759–72.PubMedGoogle Scholar
  17. 17.
    Clarke WR, Lauer RM. The predictive value of childhood cholesterol screening. JAMA 1992;267:101–2.CrossRefGoogle Scholar
  18. 18.
    National Cholesterol Education Program. Highlights of the report of the expert panel on blood cholesterol levels in children and adolescents. Am Fam Physician 1992;45:2127–36.Google Scholar
  19. 19.
    Kluger CZ, Morrison JA, Daniels SR. Preventive practices for adult cardiovascular disease in children. J Fam Pract 1991;33:65–72.PubMedGoogle Scholar
  20. 20.
    Manson JE, Tosteson H, Satterfield S, et al. The primary prevention of myocardial infarction. N Engl J Med 1992;326:1406–16.PubMedCrossRefGoogle Scholar
  21. 21.
    Steenland K. Passive smoking and the risk of heart disease. JAMA 1992;267:94–99.PubMedCrossRefGoogle Scholar
  22. 22.
    Evans CH, Karunaratne HB. Exercise stress testing for the family physician. Part I. Performing the test. Am Fam Physician 1991;45: 121–32.Google Scholar
  23. 23.
    Solberg LI, Maxwell PL, Kottke TE, Gepner GJ, Brekke ML. A systematic primary care office-based smoking cessation program. J Fam Pract 1990;30:647–54.PubMedGoogle Scholar
  24. 24.
    National Cancer Institute. Cases diagnosed between 1973 and 1987 and intercensal population estimates by race, sex, and age. Bethesda, MD: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1990.Google Scholar
  25. 25.
    Public Health Focus: Mammography. MMWR 1992;41:454–9.Google Scholar
  26. 26.
    Levine R, Tenner S, Fromm H. Prevention and early detection of colorectal cancer. Am Fam Physician 1992;45:663–8.PubMedGoogle Scholar
  27. 27.
    Selby JV, Friedman GD, Quesenberry CD, et al. A case-control study of screening sigmoidoscopy and mortality for colorectal cancer. N Engl J Med 1992;326:653–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Catalona WJ, Smith DS, Ratliff TL, et al. Measurement of a prostate specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991;324:1156–61.PubMedCrossRefGoogle Scholar
  29. 29.
    Crawford ED, Schutz MJ, Clejan S, et al. The effect of a digital rectal examination on prostate specific antigen levels. JAMA 1992;267:2227–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Bourguet CC, Hamrick GA, Gilchrist VJ. The prevalence of osteoporosis risk factors and physician intervention. J Fam Pract 1991; 32:265–71.PubMedGoogle Scholar
  31. 31.
    Thun MJ, Namboodiri MM, Health CW. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med 1991;325:1593–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Zazove P, Mehr DR, Riffin MT, et al. A criterion-based review of preventive health care in the elderly. Part 2. A geriatric health maintenance program. J Fam Pract 1992;34:320–47.PubMedGoogle Scholar
  33. 33.
    Ham RJ. Indicators of poor nutritional status in older Americans. Am Fam Physician 1992;45:219–28.PubMedGoogle Scholar
  34. 34.
    National Research Council. Panel on statistics for an aging population: the aging population in the twenty-first century. Washington, DC: NRC, 1988:54.Google Scholar
  35. 35.
    Frame PS. Health maintenance in clinical practice: strategies and barriers. Am Fam Physician 1992;45:1192–1200.PubMedGoogle Scholar
  36. 36.
    Johns MB, Howell MF, Drastal CA, et al. Promoting preventive services in primary care: a controlled trial. Am J Prev Med 1992;8: 1350.Google Scholar
  37. 37.
    Shank JC, Powell T, Llewelyn J. A five-year demonstration project associated with improvement in physician health maintenance behavior. Fam Med 1989;21:273–8.PubMedGoogle Scholar
  38. 38.
    Dickey LL, Petitti D. A patient-held minirecord to promote preventive care. J Fam Pract 1992;34:457–63.PubMedGoogle Scholar
  39. 39.
    McDowell I, Newell C, Rosser W. A follow-up study of patients advised to obtain influenza immunizations. Fam Med 1990;22: 303–6.PubMedGoogle Scholar
  40. 40.
    Ornstein SM, Garr DR, Jenkins RG, Rust PF, Arnon A. Computer-generated physician and patient reminders: tools to improve population adherence to selected preventive services. J Fam Pract 1991; 32:82–90.PubMedGoogle Scholar
  41. 41.
    Ellis LBM, Joo H, Gross CR. Use of a computer-based health risk appraisal by older adults. J Fam Pract 1991;33:390–4.PubMedGoogle Scholar
  42. 42.
    Peterson KW, Hilles SB, editors. Directory of health risk appraisals. Charlottesville, VA: Society of Prospective Medicine, 1992.Google Scholar
  43. 43.
    Aukerman GF. Developing a patient education newsletter. J Fam Pract 1991;33:304–5.PubMedGoogle Scholar
  44. 44.
    Towner P, Marvel MK. A school-based intervention to increase the use of bicycle helmets. Fam Med 1992;24:156–8.PubMedGoogle Scholar
  45. 45.
    McDonald CJ, Hui SL, Smith DM, et al. Reminders to physicians from an interactive computer medical record. Ann Intern Med 1984;100:130–8.PubMedCrossRefGoogle Scholar
  46. 46.
    Struewing JP, Pape DM, Snow DA. Improving colorectal cancer screening in a medical resident’s primary care clinic. Am J Prev Med 1991;7:75–81.PubMedGoogle Scholar
  47. 47.
    Nutting PA. Health promotion in primary medical care: problems as potential. Prev Med 1986; 15:537–48.PubMedCrossRefGoogle Scholar
  48. 48.
    Parkinson MD. Paying for prevention: recent developments and future strategies. J Fam Pract 1991;33:529–30.PubMedGoogle Scholar
  49. 49.
    Woolhandler S, Himmelstein DU. Reverse targeting of preventive care due to lack of health insurance. JAMA 1988;259:2872–4.PubMedCrossRefGoogle Scholar
  50. 50.
    Hamblin JE. Physician recommendations for screening mammography: results of a survey using clinical vignettes. J Fam Pract 1991;32:472–7.PubMedGoogle Scholar
  51. 51.
    Lurie L, Manning WG, Peterson C. Preventive care: do we practice what we preach? Am J Public Health 1987;77:801–4.PubMedCrossRefGoogle Scholar
  52. 52.
    Warner KE, Murt HA. Economic incentives for health. Annu Rev Public Health 1984;5:107–33.PubMedCrossRefGoogle Scholar
  53. 53.
    Davis K, Bialek R, Parkinson M, et al. Paying for preventive care: moving the debate forward. Am J Prev Med 1990;6:32.Google Scholar
  54. 54.
    Fries JF. Aging, natural death, and a compression of morbidity. N Engl J Med 1980;303:130–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Evan W. Kligman
  • Frank A. Hale

There are no affiliations available

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