RESUMO
BACKGROUND: Patient screening criteria for health promotion/disease prevention have become widely available in recent years, but their effect on day-to-day practice has been somewhat limited, highlighting the importance of emphasizing health promotion in family practice residency training. METHODS: To determine the extent and content of health promotion education in residency curricula and perceived shortcomings in this area, we conducted a survey of all 386 accredited family practice residency programs in the United States and Puerto Rico in February and April 1991, with a response rate of 80%. Program directors completed a two-page questionnaire on curriculum coverage of health promotion, subject areas included, and resources used. RESULTS: The survey found that 88% of residencies had a formal health promotion curriculum, with the most common topics being immunization protocols and hyperlipidemia and the least common topics being behavior change and compliance. American Academy of Family Physicians materials are the most common resources available in residencies, but the most frequently used is the US Preventive Services Task Force Report. Use of the latter resource varies by geographic location. CONCLUSION: Our study demonstrates that health promotion education is part of virtually all family practice residency training programs but also shows that use of available resources varies and that program directors find it difficult to help residents incorporate health promotion into day-to-day medical practice.
Assuntos
Educação Médica Continuada , Medicina de Família e Comunidade/educação , Promoção da Saúde , Internato e Residência , Medicina Preventiva/educação , Currículo , Humanos , Desenvolvimento de Programas , Porto Rico , Inquéritos e Questionários , Estados UnidosRESUMO
A survey of low-income areas of Los Angeles County indicates that 41 percent of nonsterile women in their childbearing years who had not made a family planning visit in three years were using some means of birth control, 21 percent were not, 25 percent were not sexually active and 13 percent were pregnant or trying to become pregnant. Given that approximately 10 percent of the respondents were using unreliable means of contraception, at least one-third of respondents were in need of effective contraception. This proportion corresponds roughly to the percentage of respondents who expressed a desire to receive family planning care from a doctor or clinic (34 percent). The percentage of women who were at risk of unwanted pregnancy but not using any method of contraception was greatest among those with incomes below poverty level and among black and Hispanic women. A comparison of survey respondents to a parallel sample of low-income women who had made a family planning visit shows that those who utilized formal family planning services were substantially more likely than those who did not to be married (40 percent vs. 32 percent) and to belong to a health maintenance organization (24 percent vs. 14 percent), whereas nonusers of formal family planning services were slightly older, on average (29.6 years vs. 28.0 years), and more likely to have other types of private health insurance (47 percent vs. 25 percent).(ABSTRACT TRUNCATED AT 250 WORDS)
PIP: A survey of low-income areas of Los Angeles County indicates that 41% of nonsterile women in their childbearing years who had not made a family planning (FP) visit in 3 years were using some means of births control, 21% were not, 25% were not sexually active and 13% were pregnant or trying to become pregnant. Given than approximately 10% of the respondents were using unreliable means of contraception, at least 1/3 of respondents were in need of effective contraception. This proportion corresponds to the % of respondents who expressed a desire to receive FP care from a doctor or clinic (34%). The % of women who were at risk of unwanted pregnancy, but not using any method of contraception was greatest among those with incomes below poverty level and among black and hispanic women. A comparison of survey respondents to a parallel sample of low-income women who had made a FP visit shows that those who utilized formal FP services were more likely than those who did not to be married (40% vs. 32%) and to belong to a health maintenance organization (24% bs. 14%), whereas, nonusers of formal FP services were slightly older, on average (29.6 vs. 28 years) and more likely to have other types of private health insurance (47% vs. 25%). In addition, 95% of those who were at risk of unintended pregnancy and who had made a FP visit were practicing contraception compared with 67% of women at risk of unintended pregnancy who had not made a visit. (Author's modified).