Act in Time -Implementation of Health Promotive Work-way in Primary Care Setting (AcTi)
- Conditions
- Health Knowledge, Attitudes, Practice
- Interventions
- Behavioral: health promotive work-way
- Registration Number
- NCT04799860
- Lead Sponsor
- Region Örebro County
- Brief Summary
The study will support implementation of a health promotive work-way in primary care setting by using external and internal facilitators, with the aim to identify effective implementation strategies and to evaluate intervention uptake. Data will be collected from multiple perspecitves.
- Detailed Description
Insufficient physical activity, hazardous use of alcohol, tobacco use and unhealthy eating habits increase the risk of cardiovascular diseases, cancer and type 2-diabetes. Health-promoting work reduces the disease risk and mortality and should thus be integrated in clinical care processes.
Despite support by the National guideline for prevention and treatment of unhealthy life-style habits, there is a chasm to bridge when integrating evidence into clinical practise. Prerequisites for changing work-ways are often underestimated and left to the individual co-workers to full fill on their own.
Too few patients are asked about life-style habits and too few receive evidence-based measures. The measures taken may also depend on sex, language, residence and caregiver's profession. The investigators strive to support the implementation of a health-promoting way of working that includes self-reporting of life-style habits before a visit and that takes measures for those with at least one unhealthy lifestyle habit.
The aim is to identify effective implementation strategies for health-promoting efforts in the primary care. The perceptions of barriers and opportunities when changing way of working from the target groups (leaders, co-workers, patients) will be used to enhance the possibility of successful implementation. Strategies are enhanced by theories of leading change. External and internal facilitators support the implementation.
The study will evaluate the effects and the implementation process at the level of leaders, patients, co-workers and organisation.
The project provides generalizable knowledge on strategies to overcome the gap between evidence and praxis, contributing to utilize an existing synthesized knowledgebase regarding health-promoting and preventative workways in a Swedish primary care setting.
It is central for the health care system to identify successful implementation strategies in order to manage their future mission.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 2300
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description health promotive work-way health promotive work-way Six primary care units that voluntarily enrolls as experimental units. The units will receive implementation support based on previous research and tailored to the specific prerequisits and context for each unit. Strategies includes involvement of target groups; informationa and interactive education;use of external and internal facilitators tarined for the purpose; systematic feedback and learning dialogs during the project. The implementation support will take approximately 12 months.
- Primary Outcome Measures
Name Time Method Change and trend from baseline documented codes in medical records Change from baseline, through study completion up to 4 to 6 months after end of implementation support specific codes are used for measures related to the guideline recommendations for grade of advice for insufficient physical activity, unhealthy eating habits, hazardous use of alcohol and tobacco use and prescribed physical activity
Change in S-NoMAD score (Swedish translation of NoMAD Change from baseline S-Nomad score up to 4 to 6 months after end of study completion 23-item questionnaire covering the constructs coherence, cognitive participation, collective action and reflexive monitoring
- Secondary Outcome Measures
Name Time Method Change in perceived appropriateness (AIM), feasability (FIM) and acceptability (IAM) of the clinical intevention. Change from baseline in AIM,IAM and FIM up to 4 to 6 months after end of implementation support Appropriateness, feasability, acceptability of the clinical intervention is rated on a 5-graded scale with 4 items per construct
Change in perceived clincial intervention by a study specific questionnaire Change from baseline up to 4 to 6 months after end of implementation support Questions related to the patients' perception on receiving the clinical intervention or not
Trial Locations
- Locations (1)
Region Örebro County
🇸🇪Örebro, Sweden