       Document 0508
 DOCN  M9490508
 TI    Improving office-based physician's prevention practices for sexually
       transmitted diseases.
 DT    9411
 AU    Rabin DL; Boekeloo BO; Marx ES; Bowman MA; Russell NK; Willis AG;
       Georgetown University School of Medicine, Washington, D.C.
 SO    Ann Intern Med. 1994 Oct 1;121(7):513-9. Unique Identifier : AIDSLINE
       MED/94346704
 AB    OBJECTIVE: To determine whether office-based interventions increase
       primary care physicians' risk assessment of and counseling practices for
       patients regarding sexually transmitted diseases and the human
       immunodeficiency virus (HIV). DESIGN: Randomized controlled clinical
       trial. SETTING: Washington, D.C., Metropolitan Statistical Area. STUDY
       PARTICIPANTS: Office-based primary care physicians (family or general
       practice, internal medicine, and obstetrics-gynecology). INTERVENTION:
       Mailed educational materials alone or coupled with a simulated patient
       instructor office visit. MEASUREMENTS: Self-reported and observed
       frequency of assessing and counseling patients regarding their risk
       factors for sexually transmitted diseases and HIV infection.
       Participants were interviewed by telephone before and after the
       intervention (n = 757). A subset of participants (n = 194) was also
       observed after the intervention by simulated patient evaluators in
       blinded office visits. RESULTS: 89% of physicians who received both
       educational materials and a simulated patient instructor visit reported
       that they reviewed the educational materials compared with 53% of those
       who only received the educational materials (P < or = 0.001). Physicians
       in the combined intervention group had higher self-reported and observed
       rates for several risk assessment questions and counseling
       recommendations than did physicians in the control group or the group
       that only received educational materials. Seventy-three percent of
       physicians of the combined intervention group reported an increase in
       counseling patients about reducing risky sexual behavior compared with
       53% of the group receiving only educational materials and 42% of the
       control group (P < or = 0.001). CONCLUSIONS: Mailed educational
       materials combined with an office visit by a simulated patient
       instructor for role-play and feedback on clinical performance increased
       the frequency of office-based physicians' risk assessment and risk
       reduction counseling of patients for sexually transmitted diseases and
       HIV infection.
 DE    Counseling  Education, Medical, Continuing/*METHODS  Feedback  Human
       HIV Infections/*PREVENTION & CONTROL  Patient Education  *Physician's
       Practice Patterns  *Practice Management, Medical  Role Playing  Sexually
       Transmitted Diseases/*PREVENTION & CONTROL  Support, Non-U.S. Gov't
       Support, U.S. Gov't, P.H.S.  CLINICAL TRIAL  JOURNAL ARTICLE  RANDOMIZED
       CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

