Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study.

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 li...

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Published in:BMC Primary Care Vol. 24; no. 1; pp. 1 - 15
Main Authors: Strid, Emma Nilsing, Wallin, Lars, Nilsagård, Ylva
Format: research tables/charts Journal Article
Published: BioMed Central 6/16/2023
Online Access:View this record in EBSCOhost
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      dt: 6/16/2023
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      pub: BioMed Central
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        10.1186/s12875-023-02079-5
        164372718
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        atl: Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study.
      aug:
        au:
          Strid, Emma Nilsing
          Wallin, Lars
          Nilsagård, Ylva
        affil: University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
      sug:
        subj:
          Health Promotion Methods
          Primary Health Care
          Program Implementation
          Life Style
          Human
          Sweden
          Female
          Male
          Qualitative Studies
          Descriptive Research
          Focus Groups
          Time Factors
          Interviews
          Interview Guides
          Consent (Research)
          Implementation Science
          Change Management
          Content Analysis
          Descriptive Statistics
          Funding Source
          Female
          Male
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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