“…Activities carried out by PH in collaborations with PC included conducting needs assessments (Billingham and Perkins, 1997; Lasker and The Committee on Medicine and Public Health, 1997; Kilduff et al ., 1998; Poulton, 2000; Wilson et al ., 2000; Bindman et al ., 2001; Gillam and Schamroth, 2002; Heller et al ., 2003; Roff, 2003; Dion, 2004; Meyrick, 2004; Brauer et al ., 2006; Brown, 2006; de Guzman, 2007; Stevenson Rowan et al ., 2007; Taylor et al ., 2007; Wedel et al ., 2007), planning programs (Cornell, 1999; Cook, 2000; Oros et al ., 2001; Desai et al ., 2003; Wedel et al ., 2007) and carrying out quality assurance and evaluation (Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Hogg et al ., 2006a; Brown et al ., 2007; de Guzman, 2007; Harris et al ., 2007). Teamwork and management activities tended to focus on supporting teams and measures to address client and service concerns or practice governance (Ciliska et al ., 1992; Wood et al ., 1994; Malcolm and Barnett, 1995; Gillam et al ., 1998; Cook, 2000; Headland et al ., 2000; Banks-Smith et al ., 2001; Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Edmonstone et al ., 2003; Riley et al ., 2003; Asaid and Riley, 2007). Professional education initiatives included academic programming (Mayo et al ., 1996; Harris et al ., 2003; Heller and Goldwater, 2004; Morgan and Kelly, 2004; Lea et al ., 2005; Kaufman et al ., 2006) and informal training initiatives (Wood et al ., 1994; Thomas et al ., 1995; Welton et al ., 1997; Gillam et al ., 1998; Cornell, 1999; Scott, 1999; Bindman et al ., 2001; Gillam and Schamroth, 2002; Harris et al ., 2003; Huston et al ., 2006; Harris et al ., 2007; Hogg and Hanley, 2008; McElmurry et al ., ...…”
Section: Resultsmentioning
confidence: 99%
“…Teamwork and management activities tended to focus on supporting teams and measures to address client and service concerns or practice governance (Ciliska et al ., 1992; Wood et al ., 1994; Malcolm and Barnett, 1995; Gillam et al ., 1998; Cook, 2000; Headland et al ., 2000; Banks-Smith et al ., 2001; Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Edmonstone et al ., 2003; Riley et al ., 2003; Asaid and Riley, 2007). Professional education initiatives included academic programming (Mayo et al ., 1996; Harris et al ., 2003; Heller and Goldwater, 2004; Morgan and Kelly, 2004; Lea et al ., 2005; Kaufman et al ., 2006) and informal training initiatives (Wood et al ., 1994; Thomas et al ., 1995; Welton et al ., 1997; Gillam et al ., 1998; Cornell, 1999; Scott, 1999; Bindman et al ., 2001; Gillam and Schamroth, 2002; Harris et al ., 2003; Huston et al ., 2006; Harris et al ., 2007; Hogg and Hanley, 2008; McElmurry et al ., 2009). Advisory board and committee participation (Alexy and Elnitsky, 1996; Kilduff et al ., 1998; Margolis et al ., 2001; Iliffe et al ., 2002; Desai et al ., 2003; Dion, 2004; Rothman et al ., 2005) and social marketing and communication campaigns about health issues (Danila et al ., 1997; Lasker and The Committee on Medicine and Public Health, 1997; Hripcsak et al ., 1999; O'Neil and Clarkson, 2002; Kearney et al ., 2005; Sanders et al ., 2008) were also reported.Figure 1Activities in Primary Care and Public Health Collaborations…”
Section: Resultsmentioning
confidence: 99%
“…Health reform and government mandates for development of teams and partnerships were important systemic factors enabling collaboration reported in UK articles (Wiles and Robison, 1994; Wood et al ., 1994; Gillam et al ., 1998; Arora et al ., 2000; Poulton, 2000; Banks-Smith et al ., 2001; Cook et al ., 2001; Jewell and Griffiths, 2001; Hurst et al ., 2002; Iliffe and Lenihan, 2003; Riley et al ., 2003; Meyrick, 2004; Shaw et al ., 2006; Brown et al ., 2007), and to a lesser extent, in articles from Canada (Shandro, 2003; Butler-Jones, 2004; Brauer et al ., 2006; Sanders et al ., 2008) and the United States (Jenkins and Sullivan-Marx, 1994; Lasker and The Committee on Medicine and Public Health, 1997). Collaboration between PC and PH occurred more commonly where initiatives had common goals such as reducing health disparities and meeting the healthcare needs of disadvantaged populations (Lasker and The Committee on Medicine and Public Health, 1997; Wilson et al ., 2000; Elster et al ., 2002; Harrison et al ., 2006; PHRED, 2006; Wedel et al ., 2007; McElmurry et al ., 2009), improving quality of care (Ferguson et al ., 1992; Alexy and Elnitsky, 1996; Lundeen et al ., 1997; Harris et al ., 2003; Heller and Goldwater, 2004), containing costs (Lambrew et al ., 1993; Voelker, 1994; Lasker and The Committee on Medicine and Public Health, 1997; Welton et al ., 1997; Hripcsak et al ., 1999; Williams et al ., 1999), enhancing evidence-informed practice (Cornell, 1999; Jordan et al ., 1998; Gillam and Schamroth, 2002; Hopayian et al ., 2005; Larson et al ., 2006) and improving emergency planning and response (Hogg et al ., 2006b; Harris et al ., 2007; Mack et al ., 2007; Pierce et al ., 2007; Taylor et al ., 2007).…”
Section: Resultsmentioning
confidence: 99%
“…In the United States, the fiscal pressures associated with providing care for a growing uninsured patient population have influenced the leverage attributed to collaboration (Lasker and The Committee on Medicine and Public Health, 1997). In the United Kingdom, efforts to integrate PC and PH began in the 1990s with the establishment of Primary Care Groups, and later Primary Care Trusts, which have a requirement to engage in strategic planning, needs assessment and service evaluation (Gillam et al ., 1998; The Change Foundation, 2009). In Canada, after decades of little progress (Hutchison et al ., 2001), PHC renewal efforts have ramped up with an unprecedented momentum (Hutchison, 2008) with growing recognition that stronger collaboration between PC and PH is needed (Dault et al ., 2004; Ontario Ministry of Health and Long Term Care, 2006; Rachlis, 2006; The Change Foundation, 2009).…”
The combined search strategy yielded 6125 articles of which 114 were included. Systemic-level factors influencing collaboration included: government involvement, policy and fit with local needs; funding and resource factors, power and control issues; and education and training. Lack of a common agenda; knowledge and resource limitations; leadership, management and accountability issues; geographic proximity of partners; and shared protocols, tools and information sharing were influential at the organizational level. Interpersonal factors included having a shared purpose; philosophy and beliefs; clear roles and positive relationships; and effective communication and decision-making strategies. Reported benefits of collaboration included: improved chronic disease management; communicable disease control; and maternal child health. More research is needed to explore the conditions and contexts in which collaboration between PC and PH makes most sense and potential gains outweigh the associated risks and costs.
“…Activities carried out by PH in collaborations with PC included conducting needs assessments (Billingham and Perkins, 1997; Lasker and The Committee on Medicine and Public Health, 1997; Kilduff et al ., 1998; Poulton, 2000; Wilson et al ., 2000; Bindman et al ., 2001; Gillam and Schamroth, 2002; Heller et al ., 2003; Roff, 2003; Dion, 2004; Meyrick, 2004; Brauer et al ., 2006; Brown, 2006; de Guzman, 2007; Stevenson Rowan et al ., 2007; Taylor et al ., 2007; Wedel et al ., 2007), planning programs (Cornell, 1999; Cook, 2000; Oros et al ., 2001; Desai et al ., 2003; Wedel et al ., 2007) and carrying out quality assurance and evaluation (Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Hogg et al ., 2006a; Brown et al ., 2007; de Guzman, 2007; Harris et al ., 2007). Teamwork and management activities tended to focus on supporting teams and measures to address client and service concerns or practice governance (Ciliska et al ., 1992; Wood et al ., 1994; Malcolm and Barnett, 1995; Gillam et al ., 1998; Cook, 2000; Headland et al ., 2000; Banks-Smith et al ., 2001; Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Edmonstone et al ., 2003; Riley et al ., 2003; Asaid and Riley, 2007). Professional education initiatives included academic programming (Mayo et al ., 1996; Harris et al ., 2003; Heller and Goldwater, 2004; Morgan and Kelly, 2004; Lea et al ., 2005; Kaufman et al ., 2006) and informal training initiatives (Wood et al ., 1994; Thomas et al ., 1995; Welton et al ., 1997; Gillam et al ., 1998; Cornell, 1999; Scott, 1999; Bindman et al ., 2001; Gillam and Schamroth, 2002; Harris et al ., 2003; Huston et al ., 2006; Harris et al ., 2007; Hogg and Hanley, 2008; McElmurry et al ., ...…”
Section: Resultsmentioning
confidence: 99%
“…Teamwork and management activities tended to focus on supporting teams and measures to address client and service concerns or practice governance (Ciliska et al ., 1992; Wood et al ., 1994; Malcolm and Barnett, 1995; Gillam et al ., 1998; Cook, 2000; Headland et al ., 2000; Banks-Smith et al ., 2001; Bindman et al ., 2001; Hurst et al ., 2002; Bourdages et al ., 2003; Edmonstone et al ., 2003; Riley et al ., 2003; Asaid and Riley, 2007). Professional education initiatives included academic programming (Mayo et al ., 1996; Harris et al ., 2003; Heller and Goldwater, 2004; Morgan and Kelly, 2004; Lea et al ., 2005; Kaufman et al ., 2006) and informal training initiatives (Wood et al ., 1994; Thomas et al ., 1995; Welton et al ., 1997; Gillam et al ., 1998; Cornell, 1999; Scott, 1999; Bindman et al ., 2001; Gillam and Schamroth, 2002; Harris et al ., 2003; Huston et al ., 2006; Harris et al ., 2007; Hogg and Hanley, 2008; McElmurry et al ., 2009). Advisory board and committee participation (Alexy and Elnitsky, 1996; Kilduff et al ., 1998; Margolis et al ., 2001; Iliffe et al ., 2002; Desai et al ., 2003; Dion, 2004; Rothman et al ., 2005) and social marketing and communication campaigns about health issues (Danila et al ., 1997; Lasker and The Committee on Medicine and Public Health, 1997; Hripcsak et al ., 1999; O'Neil and Clarkson, 2002; Kearney et al ., 2005; Sanders et al ., 2008) were also reported.Figure 1Activities in Primary Care and Public Health Collaborations…”
Section: Resultsmentioning
confidence: 99%
“…Health reform and government mandates for development of teams and partnerships were important systemic factors enabling collaboration reported in UK articles (Wiles and Robison, 1994; Wood et al ., 1994; Gillam et al ., 1998; Arora et al ., 2000; Poulton, 2000; Banks-Smith et al ., 2001; Cook et al ., 2001; Jewell and Griffiths, 2001; Hurst et al ., 2002; Iliffe and Lenihan, 2003; Riley et al ., 2003; Meyrick, 2004; Shaw et al ., 2006; Brown et al ., 2007), and to a lesser extent, in articles from Canada (Shandro, 2003; Butler-Jones, 2004; Brauer et al ., 2006; Sanders et al ., 2008) and the United States (Jenkins and Sullivan-Marx, 1994; Lasker and The Committee on Medicine and Public Health, 1997). Collaboration between PC and PH occurred more commonly where initiatives had common goals such as reducing health disparities and meeting the healthcare needs of disadvantaged populations (Lasker and The Committee on Medicine and Public Health, 1997; Wilson et al ., 2000; Elster et al ., 2002; Harrison et al ., 2006; PHRED, 2006; Wedel et al ., 2007; McElmurry et al ., 2009), improving quality of care (Ferguson et al ., 1992; Alexy and Elnitsky, 1996; Lundeen et al ., 1997; Harris et al ., 2003; Heller and Goldwater, 2004), containing costs (Lambrew et al ., 1993; Voelker, 1994; Lasker and The Committee on Medicine and Public Health, 1997; Welton et al ., 1997; Hripcsak et al ., 1999; Williams et al ., 1999), enhancing evidence-informed practice (Cornell, 1999; Jordan et al ., 1998; Gillam and Schamroth, 2002; Hopayian et al ., 2005; Larson et al ., 2006) and improving emergency planning and response (Hogg et al ., 2006b; Harris et al ., 2007; Mack et al ., 2007; Pierce et al ., 2007; Taylor et al ., 2007).…”
Section: Resultsmentioning
confidence: 99%
“…In the United States, the fiscal pressures associated with providing care for a growing uninsured patient population have influenced the leverage attributed to collaboration (Lasker and The Committee on Medicine and Public Health, 1997). In the United Kingdom, efforts to integrate PC and PH began in the 1990s with the establishment of Primary Care Groups, and later Primary Care Trusts, which have a requirement to engage in strategic planning, needs assessment and service evaluation (Gillam et al ., 1998; The Change Foundation, 2009). In Canada, after decades of little progress (Hutchison et al ., 2001), PHC renewal efforts have ramped up with an unprecedented momentum (Hutchison, 2008) with growing recognition that stronger collaboration between PC and PH is needed (Dault et al ., 2004; Ontario Ministry of Health and Long Term Care, 2006; Rachlis, 2006; The Change Foundation, 2009).…”
The combined search strategy yielded 6125 articles of which 114 were included. Systemic-level factors influencing collaboration included: government involvement, policy and fit with local needs; funding and resource factors, power and control issues; and education and training. Lack of a common agenda; knowledge and resource limitations; leadership, management and accountability issues; geographic proximity of partners; and shared protocols, tools and information sharing were influential at the organizational level. Interpersonal factors included having a shared purpose; philosophy and beliefs; clear roles and positive relationships; and effective communication and decision-making strategies. Reported benefits of collaboration included: improved chronic disease management; communicable disease control; and maternal child health. More research is needed to explore the conditions and contexts in which collaboration between PC and PH makes most sense and potential gains outweigh the associated risks and costs.
“…Costings suggested the projects undertaken were likely to be cost-effective. 423 Overall, the dearth of evidence suggests the desirability of community engagement at all stages of project development to capture the community's priorities and perspectives, and assess appropriately the costs and benefits of engagement.…”
BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Investigates a mechanism for delivering public health advice in a primary care setting--three West Yorkshire general practices--by seconding a public health physician (PHP) to each practice for six months, each practice receiving one day per week. Describes how the topics to be addressed--developing a practice plan for managing information; improving services available for Asian patients; and exploring "value for money" in fundholding--were chosen. Details the procedures and lists the main outcomes. Concludes that placing a public health physician in practices may not be the optimal approach for transferring public health knowledge, but topics important to the practice lend themselves to such an intervention, with potential long-term benefit for public health and primary care.
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