varied. For the CVD prevention programme, the correlation was strong and positive only for family physicians (rho = 0.190), while it was weak for internal medicine specialists and other physicians (rho = 0.001 and rho = 0.018, respectively) and negative for paediatricians (rho = –0.085). For the COPD prevention programme on the basic level, the correlation was strong and positive again for family physicians (rho = 0.283), while it was quite strongly negative for internal medicine specialists and other physicians (rho = –0.249 and rho = –0.184, respectively), although it was weakly positive for paediatricians (rho = 0.071). For the COPD prevention programme at the advanced level, the correlation was strong and positive for family physicians (rho = 0.262), slightly positive for internal medicine specialists (rho = 0.001) and quite strongly negative for other physicians and paediatricians (rho = –0.461 and rho = –0.260, respectively). Although most of these results did not reach statistical significance, the observed tendency was nevertheless interesting. There was a positive correlation in all of the three prevention programmes separately (rho > 0) and a significantly positive correlation for all programmes together only for family physicians (p < 0.005) (Table III). Discussion In some countries, such as Poland, primary care is provided by family physicians, internal medicine specialists, paediatricians and physicians with or without another medical speciality. Because these physicians are also involved in prevention programmes, it has become essential to ask whether the primary care physician’s specialisation (vocational training), particularly a specialisation in family medicine, is important in the delivery of these programmes. The results of the study revealed differences between the specialisations. While the involvement Prevention of CVD and COPD in Lodz of family physicians correlated well with better programme delivery, the correlation for physicians with other specialisations or without specialisation was quite different, which made the result even more noteworthy. A search of the Medline database showed papers reporting a correlation between the delivery of prevention programmes in primary care and preventive intervention, education strategies, involvement in the community, a focus on population, and remote location [10-14]. However, reviewing medical and public health journals the authors found no previous papers on the correlation between a primary health care physician’s speciality and the delivery of prevention programmes. One paper recommended the need for an economic analysis of prevention programmes [15]. The overall body of evidence showing the effectiveness of preventive activities is growing [16]. These activities should be performed in a primary care setting. Primary care physicians see two thirds of patients from their lists one or more times each year and 90% at least once in 5 years [17], so they are in an excellent position within the health care system to administer preventive care in an opportunistic manner. However, they are confronted with many difficulties in its implementation, listing such factors as: work load, lack of time, lack of reimbursement, discrepancies in guidelines, patients’ doubts about effectiveness, lack of clarity about which professional in primary care is responsible for prevention, as well as insufficient personal training in prevention and health promotion [18]. All of these difficulties create barriers, and as a consequence some studies have shown low reported rates of preventive interventions being implemented [19]. It appears that no studies have examined the possible role of family physicians in the delivery of prevention programmes, including CVD and COPD prevention programmes. In addition, other factors related to various levels of delivery of preventive care are unclear. Brotons Table III. Relationship between the proportion of physicians who delivered CVD and COPD prevention interventions and the rate of contract completion Prevention programme CVD COPD basic level COPD extended level All programmes combined* Spearman’s rank correlation coefficient for family physicians (rho) 0.190 (p > 0.05) 0.283 (p > 0.05) 0.262 (p > 0.05) 0.258 (p < 0.03) Spearman’s rank correlation coefficient for internists (rho) 0.001 (p > 0.05) –0.249 (p > 0.05) 0.002 (p > 0.05) –0.109 (p > 0.05) Spearman’s rank correlation coefficient for paediatricians (rho) –0.085 (p > 0.05) 0.071 (p > 0.05) –0.260 (p > 0.05) –0.107 (p > 0.05) Spearman’s rank correlation coefficient for other physicians (rho) 0.018 (p > 0.05) –0.184 (p > 0.05) –0.461 (p < 0.05) –0.234 (p > 0.05) *Correlation for three programmes combined (CVD; COPD, basic level; COPD, extended) Arch Med Sci 2, April / 2010 211