BackgroundPractice facilitation has proven to be effective at improving care delivery. Practice facilitators are healthcare professionals who work with and support other healthcare providers. To the best of our knowledge, very few studies have explored the perspective of facilitators. The objective of this study was to gain insight into the barriers that facilitators face during the facilitation process and to identify approaches used to overcome these barriers to help practices move towards positive change.MethodsWe conducted semi-structured interviews with four practice facilitators who worked with 84 primary care practices in Eastern Ontario, Canada over a period of five years (2007–2012). The transcripts were analyzed independently by three members of the research team using an open coding technique. A qualitative data analysis using immersion/crystallization technique was applied to interpret the interview transcripts.ResultsCommon barriers identified by the facilitators included accessibility to the practice (e.g., difficulty scheduling meetings, short meetings), organizational behaviour (team organization, team conflicts, etc.), challenges with practice engagement (e.g., lack of interest, lack of trust), resistance to change, and competing priorities. To help practices move towards positive change the facilitators had to tailor their approach, integrate themselves, be persistent with practices, and exhibit flexibility.ConclusionsThe consensus on redesigning and transforming primary care in North America and around the world is rapidly growing. Practice facilitation has been pivotal in materializing the transformation in the way primary care practices deliver care. This study provides an exclusive insight into facilitator approaches which will assist the design and implementation of small- and large-scale facilitation interventions.

The translation and implementation of research evidence into clinical practice is complex and requires consideration of real-life practicalities such as time demands on participants, staffing costs, effective recruiting and ongoing evaluation.

Objectives There are about 15.7 million people with migration background living in Germany. The number of migrants from post-soviet countries (mainly Russia, Ukraine) is increasing and this group is estimated to be the largest in Bavaria by 2020. Concurrently, working conditions have changed, for example, the deregulation of German Law on Temporary Work resulting in 2% prevalence of temporary workers of Germany's total workforce. Migrants are among the most vulnerable group affected by changing work patterns. Yet, they are among the most diffi cult to reach groups in epidemiological studies. This study aims at identifying an effi cient access way for migrants from post-soviet countries and comparing different working conditions and health between terms of employment. Methods MIROSLAWa is a population-based, cross-sectional questionnaire study conducted in Bavaria. It compares different approaches (classic mail survey, school-based, social meeting points, and web-based access; n=500 contacted persons per access way) with subjects (18-65 years) from post-sovietb countries. The primary outcome is the response across the four access ways. Secondary outcome is description of participants' work-related health. Results Field phase began in March 2011. So far, access via schools turned out to be not feasible. This is due to the fact that the Bavarian Ministry of Education gave the study a low priority. For the classic mail survey, addresses were obtained through the German population registry. Conclusions Research on occupational health in migrants needs migrant specifi c instruments. This study compares access ways and contributes to fi nd the most effi cient access way for migrants from post-soviet countries.