From policy to patient: Using a socio-ecological framework to explore the factors influencing safe practice in UK primary care

Litchfield, Ian; Perryman, Katherine; Avery, Anthony; Campbell, Stephen; Gill, Paramjit; Greenfield, Sheila

doi:10.1016/j.socscimed.2021.113906

Cited by 12 publications

(12 citation statements)

References 75 publications

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“…For the AHNP who responded to the survey, the pandemic underscored opportunities for change and many of the barriers they experienced were not unique to their practice in pediatric transplantation. The four main themes that emerged in the present study reflected some aspects of existing socio‐ecological frameworks that have been used to describe factors influencing the safe practice of health care 19 . Specific examples of how these themes paralleled the five levels included in the full model (individual, interpersonal, organizational, community, and policy) are discussed in detail below.…”

Section: Discussionmentioning

confidence: 99%

“…The four main themes that emerged in the present study reflected some aspects of existing socio-ecological frameworks that have been used to describe factors influencing the safe practice of health care. 19 Specific examples of how these themes paralleled the five levels included in the full model (individual, interpersonal, organizational, community, and policy) are discussed in detail below.…”

Section: Discussionmentioning

confidence: 99%

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An international survey of allied health & nursing professionals during the COVID‐19 pandemic: Perspectives on facilitators of & barriers to care

Piotrowski

Graham

Gold

et al. 2023

Pediatric Transplantation

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Background Allied health and nursing professionals (AHNP) are integral members of transplant teams. During the COVID‐19 pandemic, they were required to adapt to changes in their clinical practices. The goal of the present study was to describe AHNP perceptions concerning the impact of the pandemic on their roles, practice, and resource allocation. Methods An online survey was distributed globally via email by the International Pediatric Transplant Association to AHNP at transplant centers from September to December 2020. Responses to open‐ended questions were collected using an electronic database. Using a thematic analysis approach, coding was conducted by three independent coders who identified patterns in responses, and discrepancies were resolved through discussion. Results The majority of respondents (n = 119) were from North America (78%), with many other countries represented (e.g., the United Kingdom, Europe, Australia, New Zealand, South Africa, and Central and South America). Four main categories of impacts were identified: (1) workflow changes, (2) the quality of the work environment, (3) patient care, and (4) resources. Conclusions Participants indicated that the pandemic heightened existing barriers and resource challenges frequently experienced by AHNP; however, the value of team connections and opportunities afforded by technology were also highlighted. Virtual care was seen as increasing healthcare access but concerns about the quality and consistency of care were also expressed. A notable gap in participant responses was identified; the vast majority did not identify any personal challenges connected with the pandemic (e.g., caring for children while working remotely, personal stress) which likely further impacted their experiences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An international survey of allied health & nursing professionals during the COVID‐19 pandemic: Perspectives on facilitators of & barriers to care

Piotrowski

Graham

Gold

et al. 2023

Pediatric Transplantation

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“…Themes were organized according to a socio-ecological model [ 14 ] to identify specific factors influencing the decision to provide obstetric care at the level of the individual, interpersonal, organization, community, and public policy. Socio-ecological models have been used in healthcare research [ 18 – 21 ] and enable researchers to identify predictive factors beyond the individual level alone, situating the factors where improvements through policy and educational efforts could be directed. This study was approved by the Simon Fraser University (#H18-03291), University of Ottawa (#S-05–18-776), and Nova Scotia Health Authority research ethics boards (#1023561).…”

Section: Methodsmentioning

confidence: 99%

Influences on intentions for obstetric practice among family physicians and residents in Canada: an explorative qualitative inquiry

Marshall

Horrey

Moritz

et al. 2022

BMC Pregnancy Childbirth

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Background Many family medicine residency graduates indicate a desire to provide obstetric care, but a low proportion of family physicians (FPs) provide obstetric care within their practice. This suggests personal preference alone may not account for the low proportion of FPs who ultimately provide full obstetric care. If decisionmakers plan to augment the number of FPs providing obstetric care, barriers to the provision of such care must first be identified. Within this paper, we explore the perspectives of both family practice residents and early-career FPs on the factors that shaped their decision to provide obstetric care. Methods In this qualitative study, we analyzed a subset of interview data from three Canadian provinces: British Columbia, Ontario, and Nova Scotia (n = 18 family practice residents; n = 39 early-career FPs). We used thematic analysis to analyze data relevant to obstetric care practice, applying the socio-ecological model and comparing themes across participant types, gender, and province. Results Participants described influences affecting their decision about providing obstetric care. Key influencing factors aligned with the levels of the socio-ecological model of public policy (i.e., liability), community (i.e., community needs), organizational (e.g., obstetric care trade-offs, working in teams, sufficient exposure in training), interpersonal practice preferences (i.e., impact on family life, negative interactions with other healthcare professionals), and individual factors (i.e., defining comprehensive care as “everything but obstetrics”). Many participants were interested in providing obstetric care within their practice but did not provide such care. Participants’ decision-making around providing or not providing obstetric care included considerations of personal preferences and outside influences. Conclusions Individual-level factors alone do not account for the decrease in the type and amount of obstetric care offered by FPs. Instead, FPs’ choice to provide or not provide obstetric care is influenced by factors at higher levels of the socio-ecological model. Policymakers who want to encourage obstetric practice by FPs should implement interventions at the public policy, community, organizational, interpersonal, and individual levels.

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“…The first socio-ecological model [SEM] was first introduced to understand human development in the 1970s and was formalised as theory in the 1980s [ 22 ]. Since SEM was conceived in the 1970s, there have been many interpretations of SEM models to develop multilevel approaches to areas such as public health promotion, violence prevention, healthy college campuses, safe practice in primary care and bowel cancer prevention to name a few [ 23 – 26 ]. Furthermore, the Centres for Diseases and Prevention in the US who have adapted the SEM for health promotion efforts to include spheres of organisational, community and policy [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Developing a socio-ecological model for community engagement in a health programme in an underserved urban area

Caperon¹,

Saville²,

Ahern³

2022

PLoS ONE

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Despite a recent increase in community engagement in health initiatives during the COVID-19 pandemic, health inequalities and health inequities remain a serious problem for society, often affecting those in underserved communities the most. Often individualised incentives such as payment for vaccinations have been used to increase involvement in health initiatives but evidence suggests that these do not always work and can be ineffective. This paper addresses the real world problem of a lack of involvement of communities in health programmes and subsequent health inequalities. Using data from nine workshops with community members evaluating a large community health programme, we develop a socio-ecological model [SEM] of influences on community engagement in health programmes to identify holistic and systemic barriers and enablers to such engagement. To date SEM has not been used to develop solutions to improve community engagement in health programmes. Such an approach holds the potential to look beyond individualised conceptualisations of behaviour and instead consider a multitude of social and cultural influences. This knowledge can then be used to develop multi-faceted and multi-layered solutions to tackle the barriers to community engagement in health programmes. Our SEM highlights the overarching importance of the socio-cultural environment in influencing community engagement. Within the socio-cultural environment were factors such as trust, social support and community mindedness. We also found that other factors affecting community engagement fall within individual, economic, technological, political and physical environments. Such factors include engagement in community organisation governance and processes, access to and ability to use technology and access to safe outdoor spaces. We propose further testing our socioecological model in other communities.

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From policy to patient: Using a socio-ecological framework to explore the factors influencing safe practice in UK primary care

Cited by 12 publications

References 75 publications

An international survey of allied health & nursing professionals during the COVID‐19 pandemic: Perspectives on facilitators of & barriers to care

An international survey of allied health & nursing professionals during the COVID‐19 pandemic: Perspectives on facilitators of & barriers to care

Influences on intentions for obstetric practice among family physicians and residents in Canada: an explorative qualitative inquiry

Developing a socio-ecological model for community engagement in a health programme in an underserved urban area

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