C. EVERETT KOOP NATIONAL HEALTH AWARDS

Park Nicollet Medical Foundation
The Health Education Program

Evaluation Summary

II. Evaluation Results.

PNHEP outcomes studies have been conducted with HMO members and through the medical clinics where BHCAG employees receive care. Results from our ongoing evaluations show:

Improved Knowledge of Prevention Guidelines:

Employees were randomly assigned to an experimental group receiving an education guidebook on preventive services and a control group receiving unrelated health information. The intervention group was two to five times more accurate in reporting the risk-based guidelines of the U.S. Preventive Services Task Force than the control group. (2)

Reduced Unnecessary Treatment for Hypertension and Improved Hypertension Management Outcomes

Of 275 employees referred to the PNHEP Hypertension Management Program for screening, 78% had normal blood pressure. This data suggests that the use of screening techniques using multiple methods ensures that patients will not be unnecessarily treated. At entry into the management phase of our program, only 17% of patients had blood pressure within controlled limits. By the 12 month follow-up, this proportion had increased to 44% (p<.001 ), which compares to control rates of 27% in reference groups. The 6 mmHg average decrease in systolic blood pressure found in this study is associated with a 34% reduction in strokes and a 24%reduction in heart disease according to epidemiological evidences. (3)

Saved Three Dollars in Health Care Costs for Each Dollar Spent in Self-Care Education

Self Care brochures were sent to a random sample of 14,917 patients along with invitations to self-care education sessions. We had significantly less utilization for colds in the month following the program compared to a control group. Trends in the direction of decreased utilization were also found for earaches. Less net medical charges for the intervention group resulted in a 3 to 1 cost savings. (4)

Park Nicollet Health Education Program

Other evaluation studies:

Reduced Risks in Accordance with Healthy People 2000 Goals.

A randomized, controlled trial showed PNHEP worksite program participants had significantly greater improvements in blood pressure and aerobic capacity (a measure of physical fitness) and better self-reported health habits than control groups. (5,6)

Increased Physician Counseling of Employees Requesting HIV tests.

Over a six month period we provided family practice physicians with patient education resources, guidelines about HIV-antibody testing, and information about how their patient counseling practices compared to other physicians. Following this randomized, controlled intervention, a chart audit showed that documentation of patient counseling had doubled.(7)

Other PNHEP Collaborative Studies and Programs Based on External Research

PNHEP participated in the Minnesota Heart Health Program, one of the largest community based trials funded by the National Institutes of Health. Positive outcomes in smoking cessation, cholesterol and hypertension management and cardiovascular disease prevention were achieved. (8,9) We have conducted "health audits" for numerous BHCAG companies and have published our approach to worksite program evaluation. (10) PNHEP participated in the University of Michigan project comparing the effects of health screening, health education, and follow-up counseling. PNHEP manages the Wellness Center of the Ford plant which attracted one of the highest participation rates among all sites for this study nationwide. Changes in blood pressure, weight and smoking were significantly greater in sites with intensive interventions compared to those with less intensive programs. (11) PNHEP offers "Quit and Win", a smoking cessation program; six month abstinence rates were 26% for the intervention group compared to 12% for a control group. (12) A phone counseling/self study based smoking cessation program we also offer called "Free and Clear" demonstrated 23% quit rates at 16 months for those who received both self study and phone counseling versus 14% quit rates for those offered self-help materials only. (13)