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Ensuring quality preventive care: the Texas Department of Health's Put Prevention into Practice initiative.

In the current public health arena, assurance of quality clinical preventive services to all populations will be possible only if collaborations are nurtured between public health and the private sector health care delivery systems. This article explores key preventive health programs that serve as the historical context for the evolution of the Texas Department of Health-Put Prevention Into Practice (TDH-PPIP) initiative, outlines documented barriers to implementation of preventive services in primary care, and reviews national public health programs launched to reduce these barriers. Lastly, a discussion regarding the joint responsibilities of the public health and the private sector professionals in assuring quality preventive services to all populations is initiated. Collaborative efforts, such as the TDH-PPIP, initiative improve the availability and quality of clinical preventive services and, thus, result in significant advances in the public health goal of ensuring conditions in which people can be healthy.

Delivery of Health Care↗

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Put Prevention into Practice implementation model: translating practice into theory.

Put Prevention into Practice (PPIP), a national initiative promoting evidence-based clinical preventive services, was atheoretical in its approach to change. In 1994, the Texas Department of Health began demonstration projects to implement PPIP in grantee primary care sites across the state. They funded implementation and evaluation projects that resulted in eight years of experience with the process. Gathering both qualitative and quantitative data, the Texas Department of Health and the University of Texas researchers found action research essential to learning how to successfully support clinical sites in the implementation of PPIP. The researchers also found the need for on-site consultative assistance and a participatory problem-solving approach in order to produce desired systems change. A complex adaptive systems' perspective gave theoretical justification for action research, the composition of the PPIP Implementation Model, and the importance of specific adaptation by clinics. Thus, the eight-year action research project found that a state health department desiring to implement and institutionalize quality health care should focus on: (1) context-specific consultation, (2) recognition of complexity and system-level constructs, and (3) the requirement for participatory change.

Delivery of Health Care↗