Act in Time- Implementation of Health Promotive Work-way in Primary Care Setting - Evaluation of Effect- and Implementation Process (AcTi)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Health Knowledge, Attitudes, Practice
- Sponsor
- Region Örebro County
- Enrollment
- 12000
- Locations
- 1
- Primary Endpoint
- Change and trend from baseline documented codes in medical records
- Status
- Completed
- Last Updated
- 4 months ago
Overview
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, facilitators and organisation in short (4-6 months) and long term (16-18 months). 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.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Change and trend from baseline documented codes in medical records
Time Frame: 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
Time Frame: 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
Secondary Outcomes
- 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)