Detailing Action Kits contain clinical tools, resources for providers and patient education materials, promoting evidence-based best practices and chronic disease management. These materials are available for health care providers and their practices to help improve patient care related to key public health challenges. Clinical topics have been chosen largely because of their anticipated impact on morbidity and mortality. Click on the links below to view the contents of the Detailing Action Kits.
Vaccine-preventable diseases kill thousands of adults each year in New York City. Influenza and pneumonia together remain the third-leading cause of death. While immunizations are one of the most effective ways to reduce morbidity and mortality from vaccine-preventable diseases, vaccine coverage among adults in the City and across the United States remains low. Health care providers play a critical role in ensuring their patients are vaccinated. This toolkit offers evidence-based strategies and tools to improve adult vaccine coverage at the facility, practice and pharmacy level.
Alcohol-related problems are common in patients seen by primary care providers. Although most adults drink safely, some 25,000 New Yorkers are hospitalized for alcohol-related illness and injury each year, and more than 1,500 die. An estimated 15% of adult New Yorkers—nearly 900,000 people—report excessive drinking. Most of these individuals (about 70%) see a physician regularly. You and other primary care providers are uniquely positioned to intervene and help excessive drinkers cut down or stop using alcohol.
Asthma is a common disease among New York City's children and adults. People with asthma have chronic lung inflammation and episodes of airway tightening that cause symptoms such as wheezing, coughing, and shortness of breath.
Exclusive breastfeeding for the first 6 months of an infant's life has many short- and long-term health benefits for babies and mothers, including a reduction in infectious diseases and mortality during infancy, improved bonding, and maternal postpartum weight loss. Despite these benefits, relatively few women breastfeed for the recommended time period. In NewYork City (NYC), nearly 85% of postpartum women initiate breastfeeding, but at 2 months only 32% are still exclusively feeding their infant breast milk.
Unintended pregnancies can have significant adverse effects on the health of women and children. Nationally, half of all pregnancies and more than three-quarters of adolescent pregnancies are unintended. Contraceptive counseling has been shown to reduce the number of unintended pregnancies and abortions. Yet, despite high rates of unintended pregnancy and the need for contraception, fewer than half of clinicians nationally talk about contraception or provide counseling. As a healthcare professional, you can make a difference.
Cardiovascular disease is a leading cause of preventable illness and death in New York City, causing more than 25,000 deaths and more than 130,000 hospitalizations each year. Elevated low-density lipoprotein (LDL) cholesterol is a major – but modifiable – risk factor for cardiovascular disease; however, two-thirds of New Yorkers (approximately 400,000 people) who have atherosclerotic disease or diabetes have not met their LDL goal of <100 mg/dL.
Depression is one of the most commonly seen conditions in primary care. One in 4 women and 1 in 10 men will suffer from a major depressive episode during their lifetime. Nearly 6%, or 380,000, of all adult New Yorkers each year report clinically significant emotional distress. Depressive disorders play an important role in the etiology, course and outcomes associated with chronic diseases, and if untreated, depression can lead to increased disability and suicide.
Since 2002, the prevalence of diabetes has increased by nearly 50 percent among New York City adults. Recent reports indicate that 740,000 New Yorkers have diabetes and an additional 1.3 million have prediabetes, with the burden of disease falling disproportionately on minority communities of color. Of those living with prediabetes, an estimated nine out of 10 people are unaware of their condition. As a health care provider, you play a crucial role in helping your patients prevent or delay the onset of type 2 diabetes. The clinical tools, provider resources, and patient education materials in this Diabetes Action Kit will support and amplify your efforts to help patients with prediabetes and diabetes.
Access to accurate, up-to-date information is critical for medical care, but the collection and exchange of information is often slow, fragmented and error-prone. Clinicians report that in 14% of office visits, key information is lacking in patient files. Research has shown that when electronic health records (EHRs) are appropriately designed and implemented, they can help capture important patient information and improve the quality of care.
The Health Department developed this toolkit to provide basic steps and resources for HCV screening, diagnosis and referral to treatment. Join us in improving the health outcomes of all New Yorkers living with HCV.
You can get resources for HIV testing (offer of an HIV test, obtaining consent, providing results, the NYS recommended HIV testing algorithm), patient materials and for linking HIV positive individuals to care.
Each year in the U.S., 27,000 men and women get cancer caused by human papillomavirus (HPV). HPV vaccination is the most effective way to prevent these painful or deadly illnesses. HPV vaccine is recommended for boys and girls at 11-12 years of age, when HPV acquisition is low and the immune response to the vaccine is more robust. Unfortunately, New York City’s HPV vaccination rates fall dramatically short of the 2020 national goal of 80 percent three-dose coverage. Health care providers play a critical role in increasing HPV vaccination rates, and this toolkit offers helpful strategies and tools.
Hypertension is a leading risk factor for heart disease and stroke, which together account for more than 18,000 deaths in New York City. Local data suggest the rate of controlled blood pressure among patients diagnosed with hypertension is lowest among Black adults (59%), compared to White (73%), Asian (73%) and Latino adults (69%).* As a health care provider, you play a critical role in identifying hypertension, promoting self-management and supporting medication adherence to help your patients achieve blood pressure control.
*Among a subset of 300-400 New York City primary care practices that serve ~1,000,000 patients age 18-85 that had at least one visit for health care in the past year (2016). Blood pressure control is defined as <140/90 mmHg.
In 2006, New York City’s Administration for Children’s Services (ACS) investigated 63,000 reports of child abuse and neglect. Reports often involve more than one child, so approximately 90,000 children come to the attention of ACS each year. During each investigation, ACS assesses a child’s safety and takes action, as necessary, to prevent child abuse and/or neglect.
Intimate Partner Violence (IPV) refers to a pattern of physical, psychological, sexual and/or economic abuse by a current or former partner. Also known as domestic violence, IPV is a serious public health problem. Every year, approximately 4,000 women and 900 men are treated in NewYork City emergency rooms for IPV. Almost half (44%) of women killed in NYC each year are killed by their intimate partners. Aside from the risk of injury and death, IPV significantly increases the risk of other mental and physical health problems, including cardiovascular disease, diabetes, depression, stroke and asthma.
Almost 50% of Americans take at least one prescription drug. Only half of these patients take their medication correctly and many patients who receive drug prescriptions fail to fill them. Good medication adherence can prevent strokes, heart attacks, renal failure and other complications from poorly controlled diseases. Poor adherence, especially in patients with chronic illnesses, such as diabetes and heart disease, is associated with increased risk of hospitalization and death.
In New York City (NYC), 43% of elementary school children are at an unhealthy weight; more than half of these children are obese. This is a much larger proportion than expected based on the national rate. In our public high schools, 28% of the students are either overweight or obese . Overweight children have many risks, including hyperlipidemia, hypertension, type 2 diabetes, social stigmatization, and psychosocial difficulties. Providers should monitor weight status and consistently offer counseling on healthy eating and exercise to all children and adolescents, even those who are at a healthy weight.
Overweight and obesity are epidemic in New York City (NYC) and across the country. About two thirds of the US population are overweight or obese, including more than half (3,000,000) of the adults in NYC. Fortunately, obesity is preventable and as obesity rates decrease, so will chronic disease and associated mortality. In fact, even modest weight loss of 5%-7% (about 10 pounds) can improve health and decrease disease risk.
The rate of opioid analgesic overdose deaths among New Yorkers increased by 65% between 2005 and 2011. More than one overdose death involving an opioid analgesic occurred every other day on average in New York City (NYC) in 2011. Health care providers can play a central role in reversing the epidemic of opioid analgesic misuse and overdose deaths. Because of this, the Health Department is conducting door-to-door outreach to physicians, nurse practitioners and physician assistants on the safe and judicious prescribing of opioid analgesics.
Tobacco use kills an estimated 12,000 New Yorkers a year—and many more suffer daily from tobacco-related illnesses. More than two-thirds of New York City smokers try to quit every year. Smokers experience higher rates of oral conditions that can complicate dental care, including periodontal disease and oral cancer. Quitting can decrease the risk of these complications, as well as prevent other debilitations and life-threatening diseases. The clinical tools, provider resources, and patient education materials in this Smoking and Oral Health Quit Kit will support and amplify your efforts to help patients quit smoking for good.
The PrEP and PEP Action Kit includes provider and patient resources. It is structured around these core HIV prevention practices:
Smoking is the leading preventable cause of death in the United States (US). Up to one half of life-long smokers, depending on age, are expected to die of tobacco-related diseases. Smokers who die of tobacco-related diseases lose an average of 14 years of life. In New York City (NYC), smoking kills about 8,000 people a year, a third of them before age 65. Quitting at any age reduces the risk of tobacco-related diseases and prolongs life.
Tobacco use kills an estimated 12,000 New Yorkers a year—and many more suffer daily from tobacco-related illnesses. More than two-thirds of New York City smokers try to quit every year. With proper counseling and appropriate use of nicotine replacement and other pharmacotherapies including combination regimens, long-term quit rates rise as high as 20 or 30%. However, nationally, only 20% of patients receive counseling and 8% are prescribed a medication. The prevalence of smoking has declined significantly, but there are still almost 900,000 smokers in New York City. Currently, 80% of adult smokers smoke 10 or fewer cigarettes a day, half being non-daily smokers.