Performance Improvement 1995. Office of the Assistant Secretary for Health

02/01/1995

Listing of Abstract Titles

Advanced Practice Nursing Education: Strategies for the Allocation of the Proposed Graduate Nursing Education Account

Assessment of AIDS Non-Acute Care AIDS Treatment Facilities

Developing Effective Health Communication Strategies for High-Risk Youth Outside of School

Evaluating Educational Outcomes of School Health Programs

Evaluation of NDMS 1992 Open Arms Exercise and Response to Florida Hurricane Andrew

Evaluation of the 1990 U.S.-Mexico Border Sister Cities Health Initiative: Final Report

An Evaluation of WomenÕs Reproductive Health Services Provided in Community/Migrant Health Centers in Region VIII

For a Healthy Nation: Returns on Investment in Public Health

Improving the Supply, Training, and Distribution of Primary Care Providers Under Federal Health Care Reform

Integration of Support Services Into Comprehensive Primary Care

Nutritional Status Indicators of Low-Income Populations

Patterns of Care for HIV/AIDS Patients

Region IX Hepatitis B Project Final Report

Report of the American Institute of Nutrition (AIN) Steering Committee on Healthy Weight

Study Design for an Evaluation Study of the Vaccine Adverse Event Reporting System (VAERS)

A Study of the Economic Underpinnings of Vaccine Supply

Supporting Statement for a Study To Evaluate the Effects of the Use of "Put Prevention Into Practice" Materials in Primary Health Care

TITLE: Advanced Practice Nursing Education: Strategies for the Allocation of the Proposed Graduate Nursing Education Account

ABSTRACT NUMBER: 056

ABSTRACT: This project examines issues related to the Administration's proposals to establish an all-payer pool to support graduate nurse training as part of health care reform. It provides background on the advanced practice nursing workforce and outlines possible approaches to allocation of the proposed graduate nurse education (GNE) fund. Trends in nursing supply and demand are addressed, including the number of nurses in practice by type of training, geographic location, and practice setting as well as statistics on the educational programs preparing them for practice. The discussion begins with the registered nurse workforce, as these practitioners form the pool eligible for advanced practice study, and moves to a consideration of each of the four areas of advanced practice nursing specialization (nurse practitioners, nurse-midwives, nurse anesthetists, and clinical nurse specialists). Next, trends in the costs of nursing education and sources of funding available to nursing programs and their students are examined. Finally, the author puts forth strategies pertaining to the allocation of GNE funds and gives details on cost simulations under various options.

FEDERAL CONTACT OFFICE: Office of the Assistant Secretary of Health, DHHS

PERSON: Marcy Gross

PHONE NUMBER: 202/690-5824

PIC NUMBER: 5668

PERFORMER ORGANIZATION: University of Pennsylvania School of Nursing, Philadelphia, PA

P.I.: Linda H. Aiken, Ph.D., R.N., F.A.N.

TITLE: Assessment of AIDS Non-Acute Care AIDS Treatment Facilities

ABSTRACT NUMBER: 057

ABSTRACT: The purpose of the project was to evaluate how the designs of three types of AIDS treatment facilities affected the services provided in the facilities. The question addressed was whether certain facility design features either contribute to or detract from the conduct of the treatment program(s) for which the facility is used. During the 4 fiscal years beginning with 1988, the Public Health Service made grants to assist in the construction or renovation of non-acute, intermediate, and long-term care facilities for patients with AIDS or other HIV-related conditions. Projects eligible for assistance were those for (1) renovation of existing traditional health care facilities such as hospitals and nursing homes, and other than traditional health care facilities, such as residential housing, and (2) construction of new health care facilities to provide comprehensive intermediate and/or long-term care for some or all of the various stages of illness an HIV-infected person may experience. Using a case study approach, a team (consisting of an AIDS treatment professional with experience in planning and implementing non-acute AIDS treatment programs and an architect with experience in the design of health care facilities) evaluated each of six facilities built in Region IX with grant assistance. The team gathered data from grant application files, direct observation of the facilities, and interviews with project sponsors. The final report describes significant aspects of the design, construction, and program use of each facility. Strengths and weaknesses of each facility are highlighted, with recommendations for facility designers. Intended users of project findings are designers of AIDS treatment facilities and treatment staff with responsibility for facility planning.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/401-0734

PIC NUMBER: 5682

NTIS ACCESSION NUMBER: PB 95-194726

PERFORMER ORGANIZATION: ESS Architects, San Francisco, CA

P.I.: Abelardo Ruiz

TITLE: Developing Effective Health Communication Strategies for High-Risk Youth Outside of School

ABSTRACT NUMBER: 058

ABSTRACT: This focus group study generated information about the knowledge, attitudes, behaviors, beliefs, and environments of at-risk youth. Youth are considered to be at risk if they are ages 10 through 18 and regularly engage in tobacco use, substance use, unprotected sex, and/or violence. Target population data were collected through a literature review and focus groups. High-risk youth were found to be fairly knowledgeable about healthy practices, but they do not incorporate this awareness into practice. They were found to be willing to listen to trusted, credible adults in alternative settings. Project findings suggest strategies to (1) help service providers, intermediaries, families, and other adult role models to become effective health communicators; (2) focus on linked behaviors rather than categorical issues; and (3) integrate communications with programs and services. This project is the first interdepartmental communications research effort of the Public Health Service and the Departments of Justice, Education, and Transportation.

FEDERAL CONTACT OFFICE: Office of Disease Prevention and Health Promotion

PERSON: Mary Jo Deering, Ph.D.

PHONE NUMBER: 202/205-5968

PIC NUMBER: 4490

PERFORMER ORGANIZATION: S.W. Morris Company and Global Exchange

P.I.: Ruth Karimi

TITLE: Evaluating Educational Outcomes of School Health Programs

ABSTRACT NUMBER: 059

ABSTRACT: This evaluation design report presents a general framework for assessing the effects of school health intervention on students' school performance. As recognized by the Nation's health promotion and disease prevention and education agendas--Healthy People 2000 and Goals 2000--health and education are inextricably linked: good health is necessary for effective learning, and education is necessary for maintaining good health. However, robust empirical evidence of this link from well-designed evaluations does not exist. This study was undertaken to guide efforts to gather such empirical evidence. This report begins with an overview of the eight general categories of school health intervention: (1) health education, (2) health services, (3) healthy school environments, (4) school nutrition services, (5) physical education and fitness, (6) integrated school and community health promotion, (7) school counseling, and (8) health promotion for faculty and staff. It reviews the types of school performance measures and primary data sources for obtaining those measures. Measures include educational achievement (e.g., grade promotion patterns), student behaviors (e.g., attendance), and student attitudes toward school and themselves. The primary data sources are school records and student surveys. The report reviews the procedures needed to collect data from each source and the issues regarding the use of intermediate versus long-term educational outcomes. Two major design evaluation options are presented. The first option is to use data collected by national surveys by the National Center for Education Statistics. The second is to conduct multischool demonstrations, either as add-ons to existing evaluation of the health outcomes of school health programs or as new efforts to test alternative health interventions. With these options, schools gain the tools to justify not only the health importance but also the academic importance of their health programs.

FEDERAL CONTACT OFFICE: Office of Disease Prevention and Health Promotion

PERSON: James Harrell

PHONE NUMBER: 202/205-8611

PIC NUMBER: Unassigned

PERFORMER ORGANIZATION: Mathematica Policy Research, Princeton, NJ

P.I.: Craig Thornton, Ph.D.

TITLE: Evaluation of NDMS 1992 Open Arms Exercise and Response to Florida Hurricane Andrew

ABSTRACT NUMBER: 060

ABSTRACT: The National Disaster Medical System (NDMS) is a cooperative effort of public and private organizations and individuals to provide emergency medical treatment, casualty evacuation, and definitive medical care to victims of natural and manmade catastrophic disasters. This system is a cooperative effort among four Federal Departments and Agencies: the Department of Health and Human Services, the Department of Defense, the Department of Veterans Affairs, and the Federal Emergency Management Agency. The inadequate Federal response to Hurricane Andrew stimulated a number of evaluations of Federal catastrophic disaster programs and policies. These programs are usually activated by a request from the State when State resources are overwhelmed. The Office of Emergency Preparedness initiated an evaluation of NDMS emergency response, beginning with a conference to assess its performance in the Florida hurricane response. The results led to a full evaluation of the program. The results of the evaluation confirmed that NDMS is a valuable program, but it needs to be strengthened. Seven issue areas were identified, and other participants in the NDMS program were appointed to develop options and recommendations for these issue areas.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5691

PERFORMER ORGANIZATION: Maximus, McLean, VA

TITLE: Evaluation of the 1990 U.S.-Mexico Border Sister Cities Health Initiative: Final Report

ABSTRACT NUMBER: 061

ABSTRACT: This report contains an evaluation of the activities initiated by the Office of International Health during 1990-91 to enhance the presence of the Public Health Service (PHS) in the U.S.-Mexico border region, with the objective of improving public health status. The activities included the U.S.-Mexico Border Health Group, Project Consenso, and the Sister Cities Health Initiative. The evaluation provided insights into these activities to guide future PHS efforts in bilateral health activities in the U.S.-Mexico border region. There are mutual concerns over the problems of air pollution, toxic waste dumping, sewage and water contamination, traffic congestion, and lack of services. The evaluators felt that Project Consenso was a success in that it set the stage for the continuation of a management process for the conduct of bilateral activities in health. It also pointed up the unique nature of the border communities and the need for U.S. and Mexican national presence in discussions regarding what are normally local public health issues. The strongest aspect of the development of the Sister Cities Health Initiative projects was the spirit of binational cooperation exhibited by all the participants. Ongoing dialog among the participants focusing on the role of local health authorities and technical assistance were key to project development and strongly suggest the model for future progress in the border region. The intent of the Sister Cities Health projects is to reinforce and strengthen local infrastructure, and it appears that they are doing just that. There was strong sentiment for more clearly defining the PAHO Field Office role in border activities. It was felt that the office could adopt a more consultative role with public and private health institutions on the border. The report contains recommendations made by participants interviewed to facilitate the continuing process of managing binational health issues in the border region.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5628

PERFORMER ORGANIZATION: M.S. Mexico Border Health Association, El Paso, TX

P.I.: Ignacio G. Gosset, Ph.D.

TITLE: An Evaluation of Women's Reproductive Health Services Provided in Community/Migrant Health Centers in Region VIII

ABSTRACT NUMBER: 062

ABSTRACT: In 1993, a multidisciplinary interagency task force was formed to assess reproductive health services in various public health agency programs. The task force identified a gap in reproductive health care information in the community/migrant health care setting and embarked on an evaluation project to examine the regional public health information infrastructure. The evaluation study focused on a representative sample of women 20 to 44 years of age who received reproductive health care services from one of 36 study sites. A 220-item data collection instrument was designed to collect and analyze the frequency and extent of services provided. Findings were also compared across urban, rural, and frontier study populations. The demographic and utilization patterns revealed that the typical client was a married, Hispanic, employed female with a high school education, between 25 and 29 years of age. Preventive health screenings were the most highly documented health services delivered (blood pressure, weight, and pap smears). Prenatal records were consistently the most complete. Documentation for reproductive and other types of health promotion education and counseling appeared low when compared with other services. Services related to reporting of abuse and violence were the most poorly documented, followed by reporting of mental health problems. The evaluation study will provide regional programs with an information base to assess services for continuous improvement of quality of care.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5670

NTIS ACCESSION NUMBER: PB 95-193686

PERFORMER ORGANIZATION: University of Colorado Health Sciences Center, Denver, CO

P.I.: Gene W. Marsh, Ph.D.

TITLE: For a Healthy Nation: Returns on Investment in Public Health

ABSTRACT NUMBER: 063

ABSTRACT: This study describes public health programs and the role they play at the national, State, and local levels in avoiding preventable injury and illness and decreasing demand for personal care services. It also suggests the need to increase the research base on the effectiveness of public health strategies. The population-based approaches described have provided the foundation for significant improvements in health and life expectancy, including declines in heart disease and stroke, infectious disease, and motor vehicle and workplace injuries. Other successes include the virtual elimination of polio since the mid-sixties, declines of nearly 50 percent in dental decay in children since 1974, and a 70 percent reduction in childhood blood lead levels since 1976. At the same time, persistent public health problems remain (e.g., outbreaks of new infectious diseases such as AIDS and familiar diseases such as tuberculosis). Tuberculosis provides an instructive example of a strong public health program that was effective in controlling a disease that resurged when the program was dismantled, resulting in 39,000 preventable cases and $421 million in avoidable direct medical costs between 1985 and 1992. This evaluation finds that appropriate investment in public health may lead to future savings on the medical care side. For example, conservative estimates of the impact of population-based strategies aimed at heart disease, stroke, occupational injuries, motor vehicle-related injuries, low birthweight, and gunshot wounds suggest that $69 billion in medical care spending for these conditions could be averted by 2000. This reduction will be achieved through reductions in cases of heart disease and stroke, estimated to reach 8.4 million and 3.3 million cases avoided, respectively, by 2015 as a result of public health prevention strategies.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5680

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: Bryan A Luce, Ph.D.

TITLE: Improving the Supply, Training, and Distribution of Primary Care Providers Under Federal Health Care Reform

ABSTRACT NUMBER: 064

ABSTRACT: This project provided an analysis of issues related to proposals for improving the supply, training, and distribution of primary care providers as part of health care reform. Many of the health care reform proposals considered by Congress included provisions that would have changed the mechanism for making decisions with respect to the number and types of new physicians. Information provided in this report includes a chart book on the supply, training, and distribution of physicians; technical papers providing background on the need for increased numbers of generalist physicians and the rationale for proposals to control the supply of new physicians; proposals for an all-payer pool for graduate medical education; estimates of the number of physicians in research training tracks at NIH and elsewhere; and preliminary estimates of the number of advanced practice nurses and physician assistants that would be needed to substitute for physicians if the number of physician residents were reduced.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5666

PERFORMER ORGANIZATION: Center for Health Policy Research, George Washington University, Washington, DC

P.I.: Michele Solloway, Ph.D.

TITLE: Integration of Support Services Into Comprehensive Primary Care

ABSTRACT NUMBER: 065

ABSTRACT: Federally funded community and migrant health centers (C/MHCs) and other community resources, such as the Supplemental Food Program for Women, Infants, and Children (WIC) and mental health centers, are the principal resources for the prevention, detection, and treatment of a variety of health problems. The need to evaluate the integration of nutrition, mental health, social work, and dental services provided through the C/MHCs or their linkages with other community resources is evidenced by the compromised health status of underserved clients in this country. This project evaluated the integration of nutrition, mental health, social work, and dental services provided at C/MHCs with emphasis on special categorical populations, such as the HIV-infected, the homeless, substance abusers, women, and children. The final report includes analysis of the survey responses, reports of the site visits, and recommendations for techniques and strategies that can improve integration of services.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5657

NTIS ACCESSION NUMBER: PB 95-193728

PERFORMER ORGANIZATION: Wilson Yoak Associates, Jefferson City, MI

P.I.: Lorna M. Wilson, R.N., M.P.H.

TITLE: Nutritional Status Indicators of Low-Income Populations

ABSTRACT NUMBER: 066

ABSTRACT: In 1988, the Public Health Service joined with the American Institute of Nutrition (AIN) in a cooperative agreement to examine state-of-the-art techniques for measuring nutritional status and to make recommendations for a core set of nutritional status indicators for low-income populations. A workshop, several symposia, and an AIN multidisciplinary task force on core indicators of nutritional status were planned and carried out. The collected reports resulting from these activities have been compiled in a final report. The task force drew on the symposia and workshop papers in its assessment, which provides an introduction to the concept of nutritional state and the components that must be considered in identifying core indicators for its assessment in difficult-to-sample populations. These components include food security, nutritional concerns, survey coverage, and sampling concerns. Core indicators of nutrition state are suggested in the context of the purposes for which the data are used.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5658

NTIS ACCESSION NUMBER: PB 95-193736

PERFORMER ORGANIZATION: American Institute of Nutrition, Bethesda, MD

P.I.: Richard G. Allison, Ph.D.

TITLE: Patterns of Care for HIV/AIDS Patients

ABSTRACT NUMBER: 067

ABSTRACT: This study examined patterns of care for HIV/AIDS patients who received services in federally funded community health centers in New York and New Jersey. Site visits were made to a sample of six urban centers that represented different types by organizational setting (hospital-based, hospital-affiliated, and freestanding) and by health services delivery orientation (designated AIDS clinic or integrated care plan). The focus of the study was to describe the health services delivery models used by the centers or their approach to administration, organization, and operation of HIV-related health service programs and activities. The study found that despite differences in the organization of the centers, the administration and provision of services is basically the same. The report also presents findings on the types of services delivered, the role of case management, and increased demand for services by high-risk groups.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 4498

PERFORMER ORGANIZATION: Market Care, New York, NY

P.I.: George Z. Cestero

TITLE: Region IX Hepatitis B Project Final Report

ABSTRACT NUMBER: 068

ABSTRACT: The purpose of the project was to evaluate the effectiveness of hepatitis B health education/outreach program activities at six federally funded primary care centers in Region IX that target Asian and Pacific Islander patients. The carrier rate of this disease ranges from 10 to 15 percent in the Asian Pacific population in contrast to 0.3 percent in the U.S. population. The study objectives were to examine the role Southeast Asian refugee and Asian immigrant leaders play in the design and delivery of health education programs; develop criteria for measuring effective health education programs; identify effective hepatitis B health education programs; and identify the elements of effective programs. Three major barriers to the development of effective hepatitis B programs for Asian and Pacific Islander populations were identified: (1) lack of understanding of the importance of hepatitis B screening and vaccination by the patient population; (2) lack of reimbursement by third parties for hepatitis B screening and vaccines for adolescents and adults (currently, reimbursement is provided only for prenatal patients); and (3) limited availability of bilingual/bicultural interpreters trained in health education materials. The final report recommends that the following elements should be included in effective hepatitis B outreach and education programs: (1) staff who are sensitive to cultural beliefs and attitudes affecting hepatitis B; (2) reimbursement for hepatitis B screening and vaccines for all age groups; (3) translated health education materials; (4) integrated hepatitis B activities with standard patient care protocols; (5) use of ethnic media (TV, radio, newspapers, magazines); and (6) linkages with school-based health programs and other community-based outreach programs serving the high-risk Asian/Pacific Islander population.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5681

NTIS ACCESSION NUMBER: PB 95-193389

PERFORMER ORGANIZATION: Association for Asian Pacific Community Health Organization, Oakland, CA

TITLE: Report of the American Institute of Nutrition (AIN) Steering Committee on Healthy Weight

ABSTRACT NUMBER: 069

ABSTRACT: As part of a cooperative effort between the Department of Health and Human Services' Public Health Service and the American Institute of Nutrition (AIN), AIN convened a 2-day workshop to review new data and perspectives pertinent to defining "healthy weight." AIN provided transcripts of the workshop and copies of submitted materials to PHS/OASH/ODPHP. A report from the AIN Steering Committee on Healthy Weight was published in the Journal of Nutrition (124:2240-2243, 1994). The report summarizes the Steering Committee's conclusions from the workshop, including areas of agreement, and identifies issues for which further data and discussions are needed. The report has been provided to the 1994-95 Dietary Guidelines Advisory Committee for use in its deliberations on the definition of healthy weight.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5014

PERFORMER ORGANIZATION: American Institute of Nutrition, Bethesda, MD

P.I.: Richard G. Allison, Ph.D.

TITLE: Study Design for an Evaluation Study of the Vaccine Adverse Event Reporting System (VAERS)

ABSTRACT NUMBER: 070

ABSTRACT: This project provided an evaluation design to assess the functional capabilities (including reliability and data quality) of the Vaccine Adverse Event Reporting System (VAERS). It examined methods for improving reporting, followup, and analysis of VAERS data, and assessed the level of awareness about VAERS among health care providers and consumers. There are four major evaluation points: (1) the degree to which this system meets the program's needs and legislative requirements; (2) the reliability and accuracy of information submitted to it, including how well instructions are followed when completing forms; (3) management of secondary and/or followup information; and (4) the perception of VAERS among health care providers, manufacturers, and consumers.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5013

PERFORMER ORGANIZATION: Research Triangle Institute, Washington, DC

P.I.: James S. Lubalin, Ph.D.

TITLE: A Study of the Economic Underpinnings of Vaccine Supply

ABSTRACT NUMBER: 071

ABSTRACT: This project studied the economic and commercial underpinnings of ensuring an adequate supply and distribution of vaccines. The project conducted a meta-analysis of related vaccine supply studies to identify alternative models for the purchase and distribution of vaccines; the effect of scientific advances on research, development, and purchase of vaccines; the application of economic theory to the vaccine market; comparisons of vaccine distribution systems administered by vaccine manufacturers and State agencies; and the implications of purchasing vaccines from foreign firms. The final report presented findings on price increases in vaccines since 1977; factors affecting production of supply; the economics of public versus private sector supply of vaccines; and the limited importance of foreign suppliers in meeting U.S. needs. The study found, for example, that States that supply vaccines at low prices to physician offices and encourage parents to have their children vaccinated have somewhat higher rates of immunization. These and many other findings have enhanced CDC's ability to negotiate lower prices from manufacturers and have broad utility for policy and legislation.

FEDERAL CONTACT OFFICE: PHS-CDC Immunization/Vaccine Stockpile, National Vaccine Program Office

PERSON: Chester Robinson, D.P.A.

PHONE NUMBER: 301/594-6350

PIC NUMBER: 5015

PERFORMER ORGANIZATION: Mathematica Policy Research, Princeton, NJ

P.I.: Craig Thornton, Ph.D.

TITLE: Supporting Statement for a Study To Evaluate the Effects of the Use of "Put Prevention Into Practice" Materials in Primary Health Care

ABSTRACT NUMBER: 072

ABSTRACT: This project developed an evaluation instrument to measure the impact of Put Prevention Into Practice (PPIP) materials on the delivery of preventive care services by primary care providers. Data generated will help PHS develop and refine the PPIP materials and provide direction to other Federal Agencies interested in using PPIP materials in their programs. This information will help primary care providers, national primary care provider organizations, and the academic community determine the appropriate use of these materials in clinical practice and education. These data will also provide policymakers involved with the reform of the health care delivery system with information on the utility of PPIP materials in increasing the delivery of clinical preventive services by primary care providers.

FEDERAL CONTACT OFFICE: Disease Prevention and Health Promotion, and Health Planning and Evaluation

PERSON: Paul Johnson, Ph.D.

PHONE NUMBER: 202/690-7945

PIC NUMBER: 5662

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: James O. Hersey, Ph.D.

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