Expectations on Implementation of a Health Promotion Practice Using Individually Targeted Lifestyle Interventions in Primary Health Care: a Qualitative Study

Overview

Journal BMC Prim Care

Specialties Health Services
Public Health

Date 2023 Jun 16

PMID 37328813

Authors

Emma Nilsing Strid

Lars Wallin

Ylva Nilsagard

Affiliations

Soon will be listed here.

Abstract

Background: There is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals' (HCPs') perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC.

Methods: In this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis.

Results: Twelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation.

Conclusions: The HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs.

Trial Registration: This study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860 . Registered 03 March 2021.

Citing Articles

Understanding Cardiovascular Health and Lifestyle Choices Among Healthcare Professionals in Medically Underserved Regions in Illinois.

Agah G, Herrmann L, Bezold M, Yussuf M Am J Lifestyle Med. 2024; :15598276241303863.

PMID: 39651485 PMC: 11618836. DOI: 10.1177/15598276241303863.

Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals.

Nilsing Strid E, Wallin L, Nilsagard Y Scand J Prim Health Care. 2024; 42(1):201-213.

PMID: 38241166 PMC: 10851800. DOI: 10.1080/02813432.2023.2301556.

Nutrition and Emotional Health Education: The Use of Emotional Intelligence and a Plant-Based Diet to Reduce Cardiometabolic Risk.

Abu Dabrh A, Haga C, Conrad J, Perlman A, Allyse M, Albertie M Glob Adv Integr Med Health. 2023; 12:27536130231215014.

PMID: 38026440 PMC: 10656810. DOI: 10.1177/27536130231215014.

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