Experiences of the implementation of a tool for lifestyle intervention in primary health care: a qualitative study among managers and professional groups

Carlfjord, Siw; Andersson, Agneta; Lindberg, Mats

doi:10.1186/1472-6963-11-195

Cited by 12 publications

(17 citation statements)

References 31 publications

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“…no tailoring of activities to meet professional needs) was not successful in terms of uptake of the intervention. Beliefs, values and behaviours linked to professional subcultures influenced the implementation, and most professional groups found the intervention more suitable for other professionals, contributing to a low level of adherence [28]. Thus, adapting approaches to different subgroups, preferably by involving end-users, is a strategy to enhance the likelihood of success [6,8,10,22], which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 84%

Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

et al. 2012

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BackgroundTo improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme) on professionals’ self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation.MethodsA before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation) in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points.ResultsSelf-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1) an increase in the extent to which midwives in antenatal care raised issues related to men’s violence against women, 2) an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3) an increased use of motivational interviewing (MI) and separate ‘fathers visits’ in child health care 4) improvements in the supply of healthy snacks and beverages in open pre-schools and 5) increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff.ConclusionThis multisectoral programme for health promotion, based on sector-specific intervention packages developed and tested by end users, and introduced via interactive multisectoral seminars, shows potential for improving health promotion practices and collaboration across sectors. Consideration of the key facilitators and barriers for programme implementation as highlighted in this study can inform future improvement efforts.

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Section: Discussionsupporting

confidence: 84%

Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

et al. 2012

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“…One study found the information on one patient reported by a caregiver via an ICT to be insufficient , potentially impacting safety. This review also found that nurses believed that ICT could improve the quality and uniformity of care services . Additionally, nurses have reported that different ICT systems may improve accessibility and continuity of nurse care for patients .…”

Section: Resultsmentioning

confidence: 78%

“…However, one study found that the implementation of ICT in nursing practice led to fewer physical encounters with the patient . In fact, in several studies, nurses argued that ICT could not replace physical encounters with patients and that ICT had unfavourable effects on nurse–patient relationships . Some nurses view ICT as a threat to personal relationships and feel that no technological tools can replace face‐to‐face encounters or human touch .…”

Section: Resultsmentioning

confidence: 99%

“…ICT in nursing practice offers advantages for nurses’ working situations. ICT use can, for example, save time , facilitate information exchange on nonacute or unmodified actions and short‐circuit nurses’ assessments of patients . For some nurses, ICT use has improved their work environments by facilitating collaboration between nurses and colleagues both within wards and between units .…”

Section: Resultsmentioning

confidence: 99%

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The role of ICT in nursing practice: an integrative literature review of the Swedish context

Fagerström

Tuvesson

Axelsson

et al. 2016

Scandinavian Caring Sciences

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Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication.

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“…Regarding leadership, staff at all the units were confident that their manager was positive about staff discussing lifestyle issues with patients. When managers at the participating units were interviewed at the 9-month follow-up, they all seemed visionary about the implementation of the CLT, they perceived prevention as an important task, and felt a responsibility to provide preventive services [25]. Thus, both attitudes and leadership could have contributed to sustainability at all units.…”

Section: Discussionmentioning

confidence: 99%

Sustained use of a tool for lifestyle intervention implemented in primary health care: a 2‐year follow‐up

Carlfjord

Lindberg²,

Andersson

2012

Evaluation Clinical Practice

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Rational, aims and objectives Sustainability of new methods implemented in health care is one of the most central issues in addressing the gap between research and practice, but is seldom assessed in implementation studies. The aim of this study was to evaluate the implementation of a new tool for lifestyle intervention in primary health care (PHC) 2 years after the introduction, and assess if the implementation strategy used influenced sustainability.Method A computer-based lifestyle intervention tool (CLT) was introduced at six PHC units in Sweden in 2008, using two implementation strategies: explicit and implicit. The main difference between the strategies was a 4-week test period followed by a decision session, included in the explicit strategy. Evaluations were performed after 6, 9 and 24 months. After 24 months, the RE-AIM framework was applied to assess and compare outcome according to strategy.Results A more positive outcome regarding Reach, Effectiveness, Adoption and Implementation in the explicit group could be almost completely attributed to one of the units. Maintenance was low and after 24 months, differences according to strategy were negligible. ConclusionAfter 24 months the most positive outcomes regarding all RE-AIM dimensions were found in one of the units where the explicit strategy was used. The explicit strategy per se had some effect on the dimension Effectiveness, but was not associated with sustainability overall. Staff at the most successful unit earlier had positive expectations regarding the CLT and found it compatible with existing routines.3

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Experiences of the implementation of a tool for lifestyle intervention in primary health care: a qualitative study among managers and professional groups

Cited by 12 publications

References 31 publications

Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

The role of ICT in nursing practice: an integrative literature review of the Swedish context

Sustained use of a tool for lifestyle intervention implemented in primary health care: a 2‐year follow‐up

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