TABLE 1—
2003–2010 Public Health Detailing Campaigns, Key Recommendations, and Targeted Providers: New York City Department of Health and Mental Hygiene (DOHMH)
| Campaign | DOHMH Key Recommendations | Targeted Providers |
| Influenza Vaccination 2003 | All persons aged ≥ 50 y should receive an influenza vaccine every year. | Internal medicine |
| All healthy children aged 6–23 mo should receive an influenza vaccine. | Family practice | |
| All persons aged ≥ 6 mo (and their close contacts) who have a chronic medical condition should receive an influenza vaccine every year. | Pediatrics | |
| All health care workers should be vaccinated early in the influenza season. | ||
| The optimal time to receive influenza vaccine is during October and November, although vaccination should continue to March. | ||
| Colon Cancer Screening 2004 | Refer patients ≥ 50 y, or with a family history of colon cancer, for a colonoscopy. | Internal medicine |
| Colonoscopy is the New York City–recommended screening method. | Family practice | |
| Any screening method is better than no screening method at all. | ||
| Smoking Cessation 2004 | Assess smoking status and readiness to quit at every visit. | Internal medicine |
| Prescribe medications to assist patients in becoming tobacco-free. | Family practice | |
| Provide brief counseling on cessation techniques. | ||
| Asthma 2004 | Assess each patient’s asthma severity at every visit and prescribe accordingly. | Internal medicine |
| Prescribe inhaled corticosteroids, the most effective treatment for most patients with persistent asthma. | Family practice | |
| Partner with your patients; give them a written “Asthma Action Plan.” | Pediatrics | |
| Influenza Vaccination 2004 | Only people at risk for serious illness or death from influenza should be vaccinated this year. | Internal medicine |
| People aged ≥ 65 y and children aged 6–23 mo are at high risk. | Family practice | |
| Most healthy people aged 2–64 should not be vaccinated. | Pediatrics | |
| Diabetes 2005 | A - Assess hemoglobin A1c level every 3–6 mo; goal: < 7%. | Internal medicine |
| B - Measure blood pressure at every visit; goal: < 130/80 mm Hg. | Family practice | |
| C - Monitor cholesterol (low-density lipoprotein) level annually; goal: < 100 mg/dL. | ||
| S - Ask about smoking status at every visit; goal: help to quit and to establish a smoke-free home. | ||
| Contraception 2005 | Take a brief sexual history of all patients. | Internal medicine |
| Encourage the appropriate use of contraception. | Family practice | |
| Offer emergency contraception in advance and as needed. | Pediatrics | |
| Influenza Vaccination 2005 | People aged ≥ 65 y and children aged 6–23 mo should receive an annual influenza vaccine. | Internal medicine |
| All health care workers should receive an influenza vaccine to protect themselves, their families, and their patients. | Family practice | |
| Physicians can implement strategies that increase influenza vaccine coverage in their practice. | Pediatrics | |
| Hypertension 2005 | Encourage patients with hypertension and prehypertension to adopt healthy lifestyle changes. | Internal medicine |
| Prescribe thiazide diuretics as the initial drug of choice for most patients. | Family practice | |
| Aim for target blood pressure of < 140/90 mm Hg for most patients with hypertension and < 130/80 mm Hg for those with diabetes or kidney disease. | ||
| Depression Screening 2006 | Primary care physicians can effectively detect and manage depression. | Internal medicine |
| Routinely screen for depression with a simple 2-question tool (Patient Health Questionnaire-2). | Family practice | |
| Depression can be treated. Medication and psychotherapy, alone or in combination, can help most patients. | ||
| HIV Testing 2006 | Offer HIV testing as a routine part of medical care to all persons aged 18–64 y. | Internal medicine |
| Counseling requirements have been greatly reduced. | Family practice | |
| Influenza and Pneumococcal Vaccination 2006 | Vigorously recommend an influenza vaccine for all patients who need to receive one. | Internal medicine |
| Be sure you and your staff get influenza vaccines early in the season. | Family practice | |
| Continue to vaccinate into the late winter and spring. | Pediatrics | |
| Screen all patients to determine whether they need a pneumococcal vaccine. | ||
| Cholesterol 2006 | Counsel all patients on lifestyle modification, the cornerstone of cardiovascular disease prevention. | Internal medicine |
| Treat all patients with coronary or other atherosclerotic disease or diabetes to reach a low-density lipoprotein goal of < 100 mg/dL. | Family practice | |
| Consider a low-density lipoprotein goal of < 70 mg/dL for very high-risk patients. | ||
| Prescribe statins for most patients at increased risk to lower low-density lipoprotein and reduce cardiovascular events and mortality by ≥ 30%. | ||
| Alcohol Screening and Brief Intervention 2007 | Use a simple 4-question screening tool (CAGE-AID) to ask every patient about alcohol. | Internal medicine |
| Provide clear, personalized advice, and set mutually acceptable goals. | Family practice | |
| Offer information and treatment referrals. | ||
| Electronic Health Records 2007 | Adopt an electronic record that can improve the quality, safety, and efficiency of your primary care practice.Take all steps necessary to protect and secure electronic patient information. | Internal medicine |
| Family practice | ||
| Pediatrics | ||
| Obstetrics/gynecology | ||
| Child Abuse and Neglect 2007 | Report all suspected child abuse and neglect by calling the state central register. | Family practice |
| Do not assume someone else will report. You might be the only person to identify and report an abused or neglected child. | Pediatrics | |
| Adult Obesity 2008 | Assess BMI and weight history in all adult patients. | Internal medicine |
| If BMI is > 25 kg/m2, tell patient he or she is overweight, and address readiness to lose weight. | Family practice | |
| If ready, help patient set a realistic, achievable goal and a plan to achieve that goal. | ||
| Medical Reserve Corps 2008 | Distribute antibiotics or vaccine during an emergency requiring mass prophylaxis.Assist with mass sheltering operations during a coastal storm. | All health care professionals |
| Increase medical surge capacity during an influenza pandemic. | ||
| Colon Cancer Screening 2008 | Refer patients aged ≥ 50 y or patients aged ≥ 40 y with a family history of colon cancer for colonoscopy. | Internal medicine |
| Directly refer appropriate patients for colonoscopy rather than first sending patients to a gastrointestinal consultation. | Family practice | |
| Intimate Partner Violence 2009 | Screen all patients for intimate partner violence and encourage disclosure through routine inquiry and dialogue. | Internal medicine |
| Conduct a clinical assessment of all patients who disclose abuse or for whom abuse is suspected, and document findings thoroughly. | Family practice | |
| If patients disclose intimate partner violence, promptly refer them to social and legal services. | Obstetrics/gynecology | |
| Breastfeeding 2009 | Encourage and prescribe exclusive breastfeeding with no supplementation immediately following birth. | Family practice |
| Schedule a newborn visit 3–5 d after birth to assess and support breastfeeding. | Pediatrics | |
| Routinely reinforce the importance of exclusive breastfeeding. | Obstetrics/gynecology | |
| Remove formula manufacturers’ samples and educational materials from your office. | ||
| Know the breastfeeding resources in your community and encourage your patients to use them. | ||
| Influenza and Pneumococcal Vaccination 2009 | Strongly recommend the appropriate influenza vaccine(s) for all at-risk patients. | Internal medicine |
| Screen all patients to determine whether they also need pneumococcal vaccination. | Family practice | |
| Be sure you and your staff get vaccinated against both the seasonal and the novel H1N1 influenza as early as possible this fall. | Obstetrics/gynecology | |
| Continue to vaccinate high-risk patients throughout the entire influenza season. | ||
| Pneumococcal vaccine should be given to people aged ≥ 65 y and anyone with long-term health problems. | ||
| Obesity in Children 2009 | Assess all children and adolescents for overweight and obesity. | Family practice |
| Educate children, adolescents, and families about healthful eating and physical activity. | Pediatrics | |
| Work with families to set realistic goals for healthy eating and exercise. | ||
| Medication Adherence 2010 | Assess adherence and discuss possible barriers to adherence at every patient visit. | Internal medicine |
| Reconcile your medication lists with the patient’s list, adjust doses, and eliminate unneeded medications. | Family practice | |
| Prescribe once-daily formulations, less-expensive generics, and longer-lasting supplies of medicine whenever possible. | ||
| Provide tools such as pill boxes and medication logs to help patients remember to take their medications. |
Note. BMI = body mass index (defined as weight in kilograms divided by the square of height in meters).