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Put Prevention Into Practice: Consumer and Implementation Guides [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 1999-2000.

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

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Put Prevention Into Practice: Consumer and Implementation Guides [Internet].

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Personal Health Guide

Working with your health care provider to stay well is as important as getting treatment when you are sick. This Guide will help you and your health care provider make sure that you get the tests, immunizations (shots), and the guidance you need to stay healthy.

Key Records

  • Personal Information Record
  • Personal Prevention Record
  • Preventive Care For Women
  • Additional Preventive Care
  • Medication Record

How to Use the Personal Health Guide

Read the important information that begins each section. If you don't understand something, be sure to ask your health care provider about it.

Wherever the guide suggests you talk to your health care provider, be sure you do. This will help you get the answers you need to take care of your health.

After talking with your health care provider, fill in the blanks provided on certain records. This will help you to know which services you need and how often you need them. Keep this Guide in a safe place. Look at it often to make sure that you get the preventive care you need. Bring it with you every time you see a health care provider.

The records in the Guide can make it easier to keep accurate information about your health and will especially help you with details when you get treatments in the future. You can record background information on the Personal Information record. Use the Personal Prevention Record to keep track of the preventive care that you have received and/or will need in the future.

Blood Pressure

Maintaining a good blood pressure will help protect you from heart disease, stroke and kidney problems. Have your blood pressure checked regularly. Eating a healthy diet and getting regular physical activity are two ways you can help to keep your blood pressure under control. Some people will need to take medicine to help keep a healthy blood pressure.

If you have high blood pressure, talk with your health care provider about how to lower it by changing your diet, losing excess weight, exercising, or (if necessary) taking medicine. If you need to take medicine, be sure to take it every day, as prescribed.

Ask your provider how often you need your blood pressure checked and what a healthy blood pressure for you is.

  1. I need my blood pressure checked every __________ months/years.
  2. My blood pressure should be below __________/__________.

Keep track of your blood pressure by using the Personal Prevention Record.

Immunizations

Adults need immunizations (shots) to prevent serious diseases. The following are common shots that most people need:

  • Tetanus-diphtheria shot -- Everyone needs this every 10 years.
  • Rubella (German measles) shot -- If you are a woman who is considering pregnancy and you have not had a shot for German measles, you should talk to your provider.
  • Pneumococcal (pneumonia) shot -- Everyone needs this one time at about age 65.
  • Influenza (flu) shots -- Everyone over age 65 needs this every year. If you have lung, heart or kidney disease, diabetes, HIV, or cancer you may need pneumococcal and flu shots before age 65. Health care workers may also benefit from annual flu shots.
  • Hepatitis B -- If you have contact with human blood or body fluids (such as: semen or vaginal fluid), you may be at risk for hepatitis B. You may also be at risk if you have unprotected sex (vaginal, oral, or anal) or share needles during intravenous drug use. Hepatitis B shots will protect you. Health care workers should also consider getting hepatitis B shots. Discuss this with your provider.

Keep track of the immunizations you receive by using the Personal Prevention Record.

Cholesterol

Having your cholesterol checked is important, especially if you are a man age 35-65 or a woman age 45-65. Too much cholesterol can clog your blood vessels and cause heart disease and other serious problems. Your health care provider may check your levels of "bad" (LDL) and "good" (HDL) cholesterol.

You can lower your cholesterol level and keep a healthy level by changing your diet, losing excess weight and getting regular exercise.

If necessary, your provider may prescribe medication for you.

Ask your provider what a healthy cholesterol level is for you and how often you need it checked.

  1. My cholesterol should be less than __________ mg/dL.
  2. My cholesterol should be checked every __________ year(s).

If you have high cholesterol, talk with your provider about a plan for lowering it.

Keep track of your cholesterol by using the Personal Prevention Record.

Weight

Weighing too much or too little can lead to health problems. You should have your weight checked regularly by your health care provider. You can control/maintain your weight by eating a healthy diet and getting regular physical activity. For more information, see the sections on physical activity and nutrition.

Talk with your provider about what a healthy weight for you is and ways you can control your weight.

  1. I weigh __________ pounds.
  2. A healthy weight for me is between __________ and __________ pounds.

Keep track of your weight by using the Personal Prevention Record.

Colorectal Cancer

Colorectal cancer is the third leading cause of deaths from cancer. If it is caught early, it can be treated. If you are 50 years of age or older, you should have tests regularly to detect it. The tests you may have are:

  • Fecal Occult Blood Test -- to look for small amounts of blood in your stool. This test should be done yearly.
  • Sigmoidoscopy -- to look inside the rectum and colon using a small, lighted tube. Your health care provider will do this in the office or clinic. This test should be done every 5 to 10 years.

Tell your health care provider if you have had polyps or if you have a family member(s) with cancer of the intestine, breast, ovaries, or uterus, you may need testing before age 50 or more often.

Ask your health care provider at what age you need to start and how often you need these tests:

  1. I need fecal occult blood tests every __________ year(s) starting at age __________ .
  2. I need sigmoidoscopy every __________ years starting at age __________ .

Keep track of these tests by using the Personal Prevention Record.

Oral Health Care

Good oral health care is important for your teeth and general health. With proper care, your teeth will last you for life.

  • Visit your dentist regularly for checkups. Brush after meals with a soft or medium bristled toothbrush, using a toothpaste with fluoride.
  • Use dental floss daily.
  • Limit the amount of sweets you eat, especially between meals.
  • Do not smoke or chew tobacco products.
  • Ask your provider how often you should get dental checkups.
I need to visit my dentist every __________ month(s).

Keep track of your dental visits by using the Personal Prevention Record.

Preventive Care For Women

Mammogram

Women ages 40-50 should discuss when to begin getting mammograms with their health care provider. All women should begin having mammograms regularly by age 50. Some women may need mammograms earlier. A mammogram is an X-ray test that can detect a breast cancer when it is so small that it cannot be felt and when it can be most easily cured.

Talk with your health care provider about when to begin and how often to have mammograms. Make sure to tell your provider if your mother or a sister has had breast cancer. You may need to have mammograms more often than other women.

  • My mother or sister has had breast cancer (yes/no).
  • I need a mammogram every __________ year(s), starting at age __________ .
Keep track of your mammograms by using the Preventive Care Record for Women.

Pap Smear

You need to have Pap smears regularly. This simple test has saved the lives of many women by detecting cancer of the cervix early -- when it is most easily cured.

Talk to your health care provider about how often you need Pap smears.

Tell your health care provider if you have had genital warts, sexually transmitted diseases (STDs/VD), multiple sexual partners or abnormal Pap smears. You may need Pap smears more often than other women.

  1. I need a Pap smear every __________ year(s).

Keep track of your Pap smears by using the Preventive Care Record for Women.

Additional Preventive Care

Below is a list of other preventive care. If you answer yes to any of the statements, discuss whether you need screening with your health care provider.

If you:

  • Have diabetes, or if you are over age 40 and African American, or if you are over are over age 60:You should have routine eye examinations.
  • Have had sexual intercourse without condoms, have had multiple sexual partners or have had a sexually transmitted disease: You may need AIDS (HIV), syphilis, gonorrhea, chlamydia, or hepatitis tests.
  • Have injected illegal drugs or had a blood transfusion between 1978 and 1985: You may need an AIDS (HIV) and/or hepatitis test.
  • Have had a family member with diabetes, are overweight or have had diabetes during pregnancy: You may need a diabetes (glucose) test.
  • Are over age 65: You may need a hearing test.
  • Now or in the past, have ever consumed a lot of alcohol or have smoked or chewed tobacco: You may need a mouth examination.
  • Are a man 50 years of age or older: You may need a prostate examination.
  • Are a man aged 15-35 years, particularly if you have a testicle that is abnormally small or not in the normal position: You may need a testicular examination.
  • Have had skin cancer in your family or if you have had a lot of sun exposure: You may need a skin examination.
  • Have had radiation treatments of your upper body: You may need a thyroid examination.
  • Have been exposed to tuberculosis (TB), or if you have recently moved from Asia, Africa, Central or South America, or the Pacific Islands, or if you have kidney failure, diabetes, HIV, alcoholism or use illegal drugs: You may need a tuberculosis test (PPD).

Keep track of this additional preventive care using the Additional Preventive Care Record.

Tobacco Use

Don't start smoking or using smokeless tobacco. If you do smoke, quit. It is the best thing you can do to stay healthy. Ask your health care provider to help you pick a date to quit and for advice on how to keep from starting again. Before trying to quit, stop smoking in places that you spend a lot of time (like at home or in the car). Once you have quit, avoid smoking even one puff and try to keep yourself away from all cigarettes. Talk with your provider about things to do when you want a cigarette. If you fail the first time, don't give up. Keep trying and learn from your experience. Ask yourself what helped or did not help you in trying to quit. You can succeed and live a healthier and longer life.

If you have young children, your smoking may harm their health; if you quit, you will be helping them stay healthy, too.

Physical Activity

Being physically active will help you feel better and maintain a healthy weight. Regular physical activity helps to control your blood pressure and cholesterol, and strengthens your heart, muscles and bones. Even daily activities such as housework, walking, or raking leaves will help. Pick activities that you enjoy, that fit into your daily routine, and that you can do with a friend or family member. Make time to exercise, start slow, and keep at it. Start with regular walking before choosing a more difficult activity. Try for a total of 30 minutes of physical activity most days of the week.

If you do not have a regular exercise program, talk with your health care provider about ways you can start one.

Nutrition

Eating the right foods will help you live a longer, healthier life. Many illnesses -- such as diabetes, heart disease, and high blood pressure -- can be prevented or controlled through a healthy diet. It is never too late to start eating right. Follow the simple guidelines below.

Dietary Guidelines for Americans

  • Eat a variety of foods.
  • Balance the food you eat with physical activity -- maintain or improve your weight.
  • Choose a diet with plenty of grain products, vegetables, and fruits.
  • Choose a diet low in fat, saturated fat, and cholesterol.
  • Choose a diet moderate in sugars.
  • Choose a diet moderate in salt and sodium.
  • If you drink alcoholic beverages, do so in moderation. (Moderation is no more than one drink daily for women and no more than two drinks daily for men.)

Depression

We all feel "down" or "blue" at times. However, if these feelings are very strong or last for a long time, they may be due to medical illness -- depression. This illness can be treated, but is often not recognized by patients and health care providers. Some of the warning signs of depression are listed below. If you have four or more of these warning signs, be sure to talk to your provider about depression.

Warning Signs of Depression

  • Feeling sad, hopeless or guilty most of the time.
  • Loss of interest and pleasure in daily activities.
  • Sleep problems (either too much or too little).
  • Fatigue, low energy, or feeling "slowed down".
  • Problems making decisions or thinking clearly.
  • Crying a lot.
  • Changes in appetite or weight (up or down).
  • Thoughts of suicide or death.

Safety

Many serious injuries can be prevented by following basic safety rules.

  • Always wear safety belts while in the car.
  • Never drive after drinking alcohol.
  • Always wear a safety helmet while riding on a motorcycle or bicycle.
  • Use smoke detectors in your home. Change the batteries every year and check to see that they work every month.
  • If you choose to keep a gun in your home, make sure that the gun and the ammunition are locked up separately and are out of children's reach.
  • Keep the temperature of hot water less than 120 degrees Farenheit. This is especially important if there are children or older adults living in your home.
  • Prevent falls by older adults. Repair slippery or uneven walking services, improve poor lighting and install secure railings on all stairways.
  • Be alert for hazards in your workplace and follow all safety rules.

HIV and AIDS

AIDS (Acquired Immunodeficiency Syndrome) is a fatal disease that breaks down the body's ability to fight infection and illness. AIDS is caused by the HIV virus. By preventing HIV infection, you can prevent AIDS. There is currently no cure for AIDS and no vaccine to prevent HIV infection.

How Do You Get HIV?

People get HIV by coming into contact with the blood or body fluids (semen or vaginal fluid) of a person with HIV. This includes unprotected sexual intercourse and sharing needles. You cannot get infected with HIV from casual contact such as shaking hands or hugging.

How To Reduce Your Risk of Getting HIV

Do not have sex. Have sex with only one, mutually faithful, uninfected partner. Use a latex condom correctly every time you have sex. If you use drugs, do not share needles and syringes.

Family Planning

The birth of a child is a joyful event. However, having a child requires time and planning. If you are a sexually active man or woman and are not ready to have a child, you and your partner should use a reliable form of contraception. Some of the different methods of contraception are listed below. Talk with your health care provider about the best method of contraception for you and how to use it properly.

Methods of Contraception and Percent Effectiveness with Proper Use

______________________________________________________________________

Reversible Methods              Permanent Methods
______________________________________________________________________

Medications                     Sterilization

Implants (99%+)                 Vasectomy (99% +)  
Shots (99%+)                    Tubal Ligation (99%+)
Birth Control Pills (97%) 
            
Barrier Methods

Condoms (88%) 
Diaphragms (82%) 
Cervical Caps (64%-82%)
           
Spermicides (without condom)

Foams/Suppositories (79%)
 
Natural Family Planning

"The Rhythm Method" (80%)
 
Intrauterine Devices 

(IUDS) (98%)
______________________________________________________________________

Alcohol and Other Drug Use

  • Don't use illegal (street) drugs of any kind, at any time.
  • Use prescription drugs only as directed by a health care provider.
  • Use nonprescription drugs only as instructed on the label.
  • Tell your health care provider all of the medications you are currently taking.
  • If you drink alcohol, do so only in moderation -- no more than one drink daily for women and two drinks daily for men.
  • Do not drink alcohol before or while driving a motor vehicle.
  • If you have concerns about your alcohol or drug use, talk to your health care provider.

Read the questions below. A "Yes" answer to any of the questions may be a warning sign that you have a drinking problem. Talk to your health care provider.

  • Have you ever felt that you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about drinking?
  • Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

For More Information

If you would like to learn more about how to stay healthy and prevent disease, the organizations listed below provide helpful information.

  • Aging
  • National Council on Aging: (202) 479-1200
  • AIDS
  • CDC National AIDS Hotline: 800-342-AIDS
  • CDC AIDS Hotline in Spanish: 800-344-7432
  • CDC TTY Hotline for the Deaf: 800-243-7889
  • Alcohol and Drug Abuse
  • National Clearinghouse for Alcohol and Drug Information: 800-729-6686
  • Cancer
  • Cancer Information Service: 800-4-CANCER
  • Child Abuse
  • National Child Abuse Hotline: 800-422-4453
  • Food and Drug Safety
  • Food and Drug Administration, Office of Consumer Affairs: (301) 827-4420
  • Heart, Lung and Blood Diseases
  • National Heart, Lung and Blood Institute, Information Center: (301) 251-1222
  • Maternal and Child Health
  • National Maternal and Child Health Clearinghouse: (703) 356-1964
  • Mental Health
  • National Mental Health Association: 800-969-6642
  • Occupational Safety and Health
  • National Institute for Occupational Safety and Health: 800-356-4674
  • Physical Activity and Fitness
  • Aerobic and Fitness Foundation: 800-BE FIT 86
  • Safety and Injury Prevention
  • Consumer Product Safety Commission: 800-638-CPSC
  • National Highway Traffic Safety Administration, Auto Safety Hotline: 800-424-9393
  • Sexually Transmitted Diseases
  • CDC National STD Hotline: 800-227-8922

Put Prevention Into Practice

"Put Prevention Into Practice" is a national initiative of the U.S. Department of Health and Human Services' Public Health Service in partnership with public and private health care organizations (1).

The goal of "Put Prevention Into Practice" is to preserve the health of all Americans by improving the preventive care they receive.

You can help put prevention into practice by working with your health care providers to make sure that you get all the preventive care you need.

You can also do your part by following the health advice in this Personal Health Guide. Take charge of your health and live a longer and healthier life!

(1) Neither the U.S. Public Service nor the U.S. Department of Health and Human Services endorses any particular product, service, or organization.

Current as of April 1998 Publication No. APPIP 98-0027

Internet Citation:Personal Health Guide: Put Prevention into Practice. Consumer Information, April 1998. Publication No. APPIP 98-0027. Agency for Health Care Policy and Research, Rockville, MD. http://hstat.nlm.nih.gov/ftrs/dbaccess/ppipp

Key Records

Personal Information

Staying on top of your health history can be challenging. The records in this Guide can help you keep track of information. First, record your background information here. You can access other records for preventive tests and exams (shots), women's health exams, additional preventive care measures, and medications.

Name:_________________________________________________________________


Address: _____________________________________________________________
           
______________________________________________________________________

______________________________________________________________________            


Telephone: ___________________________________________________________


In an emergency, contact:

______________________________________________________________________


Allergies: ___________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________



Health care provider phone number(s) 

______________________________________________________________________

______________________________________________________________________


Medical insurance number(s):  ________________________________________

______________________________________________________________________

Personal Prevention Record

Use this Personal Prevention Record to keep track of the preventive care that you have received and/or will need in the future. With the help of your health care provider, fill in how often you need each type of preventive care. Write in the date each time you receive preventive care. Use the remaining space to record other information (such as results of tests and the health care provider's or clinic's name). Use the records for Preventive Care For Women, Additional Preventive Care, and Medication to keep track of other important medical information.

Type of Preventive Care       Enter Dates, Results, and Other Information


Blood pressure                _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   

Goal: _____/_____             _________   _________   _________   _________   


Cholesterol                   _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   

Goal: _____ mg/dl             _________   _________   _________   _________   


Weight                        _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   

Goal: _____ lbs.              _________   _________   _________   _________   


Fecal occult blood test       _________   _________   _________   _________   

Every _____ years             _________   _________   _________   _________   


Sigmoidoscopy                 _________   _________   _________   _________   

Every _____ years             _________   _________   _________   _________   


Tetanus (Td) shot             _________   _________   _________   _________   

Every 10 years                _________   _________   _________   _________   


Pneumococcal shot             _________   _________   _________   _________   

Once at age 65                _________   _________   _________   _________   


Influenza shot                _________   _________   _________   _________   

Every year starting at age 65 _________   _________   _________   _________   


Dental visits                 _________   _________   _________   _________   

Every _____ months            _________   _________   _________   _________   

Preventive Care for Women

Use this record to keep track of how often you need each type of preventive care and how often you receive care in the future. Write in the date and other information (such as results of tests and health care provider's or clinic's name) when you receive care.

Type of Preventive Care       Enter Dates, Results, and Other Information


Mammogram                     _________   _________   _________   _________   

Every _____ years             _________   _________   _________   _________   


Pap smear                     _________   _________   _________   _________   

Every _____ years             _________   _________   _________   _________   

Additional Preventive Care

____________________________________________________________________________

Type of Preventive Care       Enter Dates, Results, and Other Information

____________________________________________________________________________


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________   


____________________          _________   _________   _________   _________   

Every _____ months/years      _________   _________   _________   _________    

Medication Record

Medication Name                    Dose                How Often


 


______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________



______________________________     _______________     _______________

Pub. No. APPIP 98-0027

Because the print version of the Guide is pocket-size, it is easy to use and take to the doctor's office. Single print copies of Personal Health Guide: Put Prevention into Practice (Pub. No. APPIP 98-0027) are available free of charge from the AHCPR Publications Clearinghouse; call toll-free 800-358-9295. Select to access the online version of the other consumer guide in this series, Child Health Guide: Put Prevention into Practice.

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