Health promotion and disease prevention in general practice and primary care: a scoping study

Abstract

This paper reports the findings of a scoping review on the organisation and delivery of health improvement activities in general practice and the primary healthcare team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices and how individual practices and the primary healthcare team organise such public health activities and how these contribute to health improvement. Our focus was on health promotion and prevention activities and aimed to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary healthcare team. Many of the research studies reviewed had some details about the type, process, location or who provided the intervention. 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. Although many GPs do not take a population approach and focus on individual patients some do 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. Based on our analysis we conclude that there is insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care.

Effects of a systematically offered social and preventive medicine consultation on training and health attitudes of young people not in employment, education or training (NEETs): An interventional study in France

“…Yet it is more than likely that the barriers to accessing preventive and social medicine consultations that are described in the general population are even greater in this population. In primary care, it is unfortunate that such primary care practices–focused on health promotion and disease prevention–are not widely practiced and accessible [27,28]. Different reasons can explain this at three different levels: at the physician level (e.g., uncertainty due to conflicting recommendations, a lack of time, and a lack of knowledge of young people’s needs and expectations), at the patient level (e.g., fear of consulting a doctor, unawareness of services and their benefits, a lack of autonomy, competition with other basic needs), and, lastly, at the health-care system level (e.g., a lack of low-threshold services and/or services integrated into the social services dedicated to these underserved, hard-to-reach populations) [29].…”

<b>Avaliação no sistema de saúde brasileiro /Evaluation in the brazilian health system<b>

“…A utilização da avaliação na saúde se faz presente desde a Grécia antiga, quando os filósofos se referiam ao uso de padrões de conhecimento na área médica (6) . A partir do século XX, a avaliação na área de saúde estabeleceu suas premissas no contexto histórico, com Abrahan Flexner, o qual realizou, em 1910, um trabalho de acreditação em várias escolas médicas nos Estados Unidos e Canadá (6,7) .…”

“…A utilização da avaliação na saúde se faz presente desde a Grécia antiga, quando os filósofos se referiam ao uso de padrões de conhecimento na área médica (6) . A partir do século XX, a avaliação na área de saúde estabeleceu suas premissas no contexto histórico, com Abrahan Flexner, o qual realizou, em 1910, um trabalho de acreditação em várias escolas médicas nos Estados Unidos e Canadá (6,7) . Após aproximadamente 30 anos, o Colégio Americano de Cirurgiões buscou parcerias com outras associações voluntárias, contribuindo para a criação da Joint Commissionon Accreditation of Hospitals, empresa privada que se propôs a introduzir, na cultura médico-hospitalar, leis mais complexas na área da saúde.…”

Profiles of General Practice in a China's General Hospital

“…It focuses not only diseases but human itself 2 ,and general practice or primary care is gatekeeper for health promotion that provides the first-contact health care 3 . Strengthening primary care plays an important role in improving overall health outcomes 4 .In many European countries 5 , strengthening primary care is considered as a key element in health promotion,and most reforms focus on creating an accessible, comprehensive, continuous, and coordinated health-care system 6 .…”