Act in Time- Implementation of Health Promotive Work-way in Primary Care Setting - Evaluation of Effect- and Implementation Process (AcTi)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 12,000
- 试验地点
- 2
- 主要终点
- Change in S-NoMAD score (Swedish translation of NoMAD
研究概览
简要总结
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.
详细描述
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, facilitators and organisation in short (4-6 months) and long term (16-18 months).
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •for co-workers:
- •being a caregiver meeting patients and/or
- •being assigned a role as internal or external facilitator in the project
- •Inclusion criteria for patients filling in the study specific questionnaire:
- •18 years or older
- •visiting primary care units a specific time pre- or post implementation support
- •Inclusion criteria for personcentered processmapping:
- •* : having one or more unhealthy life-style habit 18 years or older
- •Inclusion criterina for managers:
- •* being a manager at a primary care unit or at higher level
排除标准
- 未提供
结局指标
主要结局
Change in S-NoMAD score (Swedish translation of NoMAD
时间窗: 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
Change and trend from baseline documented codes in medical records
时间窗: Change from baseline (6 months), through study completion up to 18 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
时间窗: Change from baseline S-Nomad score up to 16 to 18 months after end of study completion
23-item questionnaire covering the constructs coherence, cognitive participation, collective action and reflexive monitoring
次要结局
- Change in perceived clincial intervention by a study specific questionnaire(Change from baseline up to 4 to 6 months after end of implementation support)
- 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)
- Change in perceived clincial intervention by a study specific questionnaire(Change from baseline up to 4 to 6 months after end of implementation support)
- Change in perceived appropriateness (AIM), feasability (FIM) and acceptability (IAM) of the clinical intevention.(Change from baseline in AIM,IAM and FIM up to 16 to18 months after end of implementation support)