Practice-, Provider-, and Patient-level interventions to improve preventive care: Development of the P3 Model

• Type of Material: Article
• Authors: Robert A. Bednarczyk, Emory University; Allison Chamberlain Chamberlain, Emory University; Kara Mathewson, Emory University; Daniel A. Salmon, Johns Hopkins Bloomberg School of Public Health; Saad B Omer, Emory University
• Language: English
• Date: 2018-09-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pmedr.2018.06.009
• Title of Journal or Parent Work: Preventive Medicine Reports
• ISSN: 2211-3355
• Volume: 11
• Start Page: 131
• End Page: 138
• Grant/Funding Information: This work was supported in part by the National Institutes of Health [grant number K01AI106961 (Bednarczyk); grant number R01AI110482 (Omer, Salmon, Chamberlain)].
• Keywords: Cancer prevention and control; Behavior change; Immunization; Health promotion; Behavior change theory
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

For adequate provision of preventive services, there is an interplay between activities at the healthcare practice, healthcare provider, and patient levels of the clinical encounter. Commonly used health promotion and behavior theoretical models address some of these three levels, but none fully account for all three. Building off of key components of many existing theoretical models, including the Health Belief Model, Theory of Planned Behavior/Theory of Reasoned Action, Social Cognitive Theory, Social Ecological Model, and the Systems Model of Clinical Preventive Care, we describe the development of the P3 (Practice-, Provider-, and Patient-level) Model for preventive care interventions. The P3 Model accounts for all three levels of the clinical encounter, and the factors that impact these levels, concurrently. This yields a model for preventive care that is applicable and adaptable to different settings, and that provides a framework for the development, implementation, and evaluation of preventive care promotion interventions. The applicability of the P3 Model is shown through two exemplar preventive care programs – immunization and colorectal cancer screening. The P3 Model allows interventions to be developed and evaluated in a modular approach, to allow more practical refinement and optimization of the intervention.