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  1. Enhancing physician adoption of practice guidelines : dissemination of influenza vaccination guideline using a small-group consensus process.

    Article - En anglais


    A dissemination intervention to facilitate adoption of a preventive practice guideline in group practices was developed and evaluated.

    The intervention, small-group consensus process, started with a physician expert presenting the guideline and followed with the group participating in a structured discussion of ways to implement the guideline that culminated in a public commitment to adopt the guideline.


    Thirteen group practices and their primary care physicians (mean size, 5) were assigned randomly to intervention or control arms.

    In each group practice, physicians in the intervention arm met for 1 hour.

    Control physicians participated in an unrelated discussion (non-steroidal drug use).

    Guideline adoption was determined by changes in physicians'vaccination rates that were obtained through prechart and postchart reviews of 51 physicians.

    Prequestionnaires and postquestionnaires measured influenza knowledge and prevention attitudes.


    Using analysis of covariance, the small-group consensus process was found to increase physician vaccination rates by 34% compared with the control arm (F (1,48)=19.49).

    All intervention arm physicians increased vaccination rates from before to after compared with 54% of control arm physicians.

    Attitudes and knowledge did not change and were unrelated to increased vaccination rates, Conclusions : A case is made for the small-group consensus process as an effective utilization-focused dissemination method.

    Mots-clés Pascal : Grippe, Vaccination, Prévention, Vieillard, Virose, Infection, Homme

    Mots-clés Pascal anglais : Influenza, Vaccination, Prevention, Elderly, Viral disease, Infection, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0252142

    Code Inist : 002B30A01C. Création : 01/03/1996.