Act in Time -Implementation of Health Promotive Work-way in Primary Care Setting (AcTi)

Region Örebro County

Status: Completed

Conditions: Health Knowledge, Attitudes, Practice

Treatments: Behavioral: health promotive work-way

Study type: Interventional

Funder types: Other

Identifiers

NCT04799860

275301

Details and patient eligibility

About

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.

Full 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.

Enrollment: 12,000 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria 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

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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12,000 participants in 2 patient groups

health promotive work-way

Experimental group

Description:

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.

Treatment:

Behavioral: health promotive work-way

Control

No Intervention group

Description:

Six primary care centers of similar size and socioeconomic background in the population listed to each center.