Background: The Active Script Programme (ASP) aimed to increase the number of general practitioners (GPs) in Victoria, Australia who deliver appropriate, consistent, and effective advice on physical activity to patients. To maximise GP participation, a capacity building strategy within Divisions of General Practice (DGPs) was used. The objectives of the programme were to (a) train and support GPs in advising sedentary patients, and (b) develop tools and resources to assist GPs. Objective: To evaluate the effectiveness of the ASP. Methods: A systems approach was used to promote capacity in Victorian general practice. Economic analyses were incorporated into the programme's evaluation. Participants were selected DGPs and their GP members. The programme worked with DGPs to train GPs and provide relevant resources. The main outcome measures were (a) changes in GP knowledge and behaviour and (b) cost effectiveness, based on modelled estimates of numbers of patients advised and adopting physical activity and gaining the associated health benefits. Results: GP awareness and provision of physical activity advice increased. Although the programme's reach was modest, based on actual GP involvement, the cost effectiveness figures ($138 per patient to become sufficiently active to gain health benefits, and $3647 per disability adjusted life year saved) are persuasive. Conclusions: The ASP increased DGPs' capacity to support GPs to promote physical activity. There is a strong economic argument for governments to invest in such programmes. However, caution is warranted about the maintenance of patients' activity levels. Programme refinement to encourage GPs to use community supports more effectively will guide future development. Further research on long term patient adherence through a multisectorial approach is warranted.
The short paper that follows is fundamentally about evidence-based practice. In Kuruvilla, Mays, Pleasant and Walt's (2006) terms it was an exercise in the application of research to service development and evidence-based practice. In Walter, Nutley, and Davies' (2003) taxonomy it resulted in a professional intervention, the development of which was led by research users seeking evidence to inform practice development. The team emerged out of a social network of individuals interested in partnership development issues (Kalucy, McIntyre, & Jackson-Bowers, 2007). The resulting paper was the foundation for a significant investment, by the Department of Human Services, in building capacity for partnership leadership in Victoria. The team that undertook this research-to-practice project consisted of three Primary Care Partnership (PCP) executive officers/managers, one of whom was also executive officer to the Statewide Chairs and Managers Group, a university researcher, and a final year undergraduate student working as a volunteer. The executive officer to the Statewide Chairs and Managers Group formed the team to explore broad issues of PCP development and to report to the chairs. The Statewide Chairs and Managers Group was the pathway through which the group's work would reach decision-makers. After a series of meetings to clarify the issues to be addressed, a developmental process for working with the chairs and managers was designed. The executive officers/managers were key to clear issue definition and appropriate process; the researcher to linking the issues to the partnership evidence base. The process relied on tapping the tacit knowledge of PCP managers and chairs and relating this to the relevant body of research. In this process implicit learning needs in regard to partnership leadership were articulated within a framework developed out of a complex research project undertaken with similar partnerships elsewhere. The university researcher on the team had a long history of research into partnerships and networks in the field of primary health care. The specific research project in question was a National Health and Medical Research Council-funded study of trust in the relationships between organisations in a Primary Care Partnership. The study of trust in a partnership is necessarily a study of partnership processes more generally. It was the general learning about partnership processes from this and related research that turned out to be so useful for the service system. The report of this work, that follows, was written in a form suitable for decision-making. It is not a research report but it is built on strong research-based frameworks that were "tested" in the local context. The recommendations are specific to PCPs in Victoria but will also be familiar to partnership workers elsewhere. The predicted effects of the recommendations are supported by research evidence.
Recruitment of participants to health education programs is a challenge often encountered in community health care settings. This paper outlines the process used to identify what strategies, approaches and messages raise community awareness of risk factors for type 2 diabetes and elicit action on the part of individuals to address risk factors. Consumer focus groups were conducted to explore people’s concerns, knowledge and beliefs around prevention of diabetes and with an aim to identify marketing messages and strategies for engaging participants in a diabetes prevention program. Findings from the focus groups were used to develop marketing messages that were then tested in further consumer consultations. They identified commonalities and differences between cultural groups. The key common point in relation to the marketing messages was the need to emphasise the consequences of type 2 diabetes and the individual relevance of risk factors. The importance of receiving information from trusted health professionals and the need to personalise messages of risk and encourage individual action was also highlighted in the research and incorporated into marketing and recruitment strategies.
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