Opportunistic approaches for delivering preventive care in illness visits

Deborah Cohen, Barbara DiCicco-Bloom, Pamela Ohman Strickland, Adrienne Headley, John Orzano, Jeffery Levine, John Scott, Benjamin Crabtree

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective. To describe how clinicians create opportunities to deliver preventive care in illness visits and assess the impact this has on preventive service delivery. Method. Detailed and descriptive fieldnotes were collected from 18 purposefully selected family practices, including direct observations of 53 primary care clinicians and 1620 patient encounters. Conversation analysis was used to examine the conversational techniques employed to deliver four preventive services (smoking counseling, immunization delivery, mammography, and cervical cancer screening) in illness visits. Qualitative data was coded and analyzed to assess impact on preventive service delivery rates. Results. Two methods for opportunistic preventive service delivery were observed. In the first, clinicians used the close of the medical encounter to make arrangement for follow-up preventive care. In the second approach, clinicians use a stepwise conversational device to exit talk about the patient's presenting problem and enter into relevant health habit advice. Quantitative analyses show that opportunistic methods are rarely used to deliver preventive services in illness visits. The stepwise technique was the most frequently used method. Patients treated by clinicians who used opportunistic techniques to deliver preventive care in illness visits were more likely to be up-to-date on smoking counseling and cervical cancer screening than those patients who were treated by clinicians who did not use opportunistic approaches. Conclusions. Opportunistic preventive service delivery in illness visits can be an efficient and effective way to deliver preventive care. Although infrequently used, quantitative data suggest that the use of opportunistic approaches to deliver preventive services during illness visits can enhance preventive care rates. Interventions aimed at helping clinicians develop effective strategies for offering preventive care during illness visits may be an important complement to existing mechanical interventions that might, by themselves, be insufficient to improve preventive care.

Original languageEnglish (US)
Pages (from-to)565-573
Number of pages9
JournalPreventive Medicine
Volume38
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Preventive Medicine
Early Detection of Cancer
Uterine Cervical Neoplasms
Counseling
Smoking
Aftercare
Family Practice
Mammography
Habits
Immunization
Primary Health Care
Equipment and Supplies
Health

Keywords

  • Communication
  • Illness
  • Opportunistic
  • Preventive care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cohen, D., DiCicco-Bloom, B., Strickland, P. O., Headley, A., Orzano, J., Levine, J., ... Crabtree, B. (2004). Opportunistic approaches for delivering preventive care in illness visits. Preventive Medicine, 38(5), 565-573. https://doi.org/10.1016/j.ypmed.2003.11.013

Opportunistic approaches for delivering preventive care in illness visits. / Cohen, Deborah; DiCicco-Bloom, Barbara; Strickland, Pamela Ohman; Headley, Adrienne; Orzano, John; Levine, Jeffery; Scott, John; Crabtree, Benjamin.

In: Preventive Medicine, Vol. 38, No. 5, 05.2004, p. 565-573.

Research output: Contribution to journalArticle

Cohen, D, DiCicco-Bloom, B, Strickland, PO, Headley, A, Orzano, J, Levine, J, Scott, J & Crabtree, B 2004, 'Opportunistic approaches for delivering preventive care in illness visits', Preventive Medicine, vol. 38, no. 5, pp. 565-573. https://doi.org/10.1016/j.ypmed.2003.11.013
Cohen D, DiCicco-Bloom B, Strickland PO, Headley A, Orzano J, Levine J et al. Opportunistic approaches for delivering preventive care in illness visits. Preventive Medicine. 2004 May;38(5):565-573. https://doi.org/10.1016/j.ypmed.2003.11.013
Cohen, Deborah ; DiCicco-Bloom, Barbara ; Strickland, Pamela Ohman ; Headley, Adrienne ; Orzano, John ; Levine, Jeffery ; Scott, John ; Crabtree, Benjamin. / Opportunistic approaches for delivering preventive care in illness visits. In: Preventive Medicine. 2004 ; Vol. 38, No. 5. pp. 565-573.
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