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. 2021 Sep 2;ahead-of-print(ahead-of-print):349-367.
doi: 10.1108/JHOM-12-2020-0512.

Barriers and facilitators in the implementation of an evidence-based health promotion intervention in a primary care setting: a qualitative study

Heather L Rogers  1   2 , Susana Pablo Hernando  3 , Silvia Núñez-Fernández  1 , Alvaro Sanchez  3 , Carlos Martos  4 , Maribel Moreno  5 , Gonzalo Grandes  3
Affiliations

Barriers and facilitators in the implementation of an evidence-based health promotion intervention in a primary care setting: a qualitative study

Heather L Rogers et al. J Health Organ Manag. .

Abstract

Purpose: This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.

Design/methodology/approach: Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.

Findings: The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.

Originality/value: Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.

Keywords: Health promotion; Healthcare management; Healthcare organization; Implementation science; Primary care.

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References

    1. Alageel , S. , Gulliford , M.C. , McDermott , L. and Wright , A.J. ( 2018. ), “ Implementing multiple health behaviour change interventions for cardiovascular risk reduction in primary care: a qualitative study ”, BMC Family Practice , Vol. 19 No. 1 , pp. 1 - 12 . - PMC - PubMed
    1. Bauer , U.E. , Briss , P.A. , Goodman , R.A. and Bowman , B.A. ( 2014. ), “ Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA ”, The Lancet , Vol. 384 , pp. 45 - 52 . - PubMed
    1. Brotons , C. , Björkelund , C. , Bulc , M. , Ciurana , R. , Godycki-Cwirko , M. , Jurgova , E. , Kloppe , P. , Lionis , C. , Mierzecki , A. , Piñeiro , R. , Pullerits , L. , Sammut , M.R. , Sheehan , M. , Tataradze , R. , Thireos , E.A. and Vuchak , J. ( 2005. ), “ Prevention and health promotion in clinical practice: the views of general practitioners in Europe ”, Preventive Medicine , Vol. 40 No. 5 , pp. 595 - 601 . - PubMed
    1. Busse , R. , Blümel , M. , Scheller-Kreinsen , D. and Zentner , A. (Eds) ( 2010. ), Tackling Chronic Disease in Europe: Strategies, Interventions and Challenges , European Observatory on Health Systems and Policies; , Copenhagen: .
    1. Conill , E.M. , Xavier , D.R. , Piola , S.F. , Silva , S.F. , da Barros , H.S. and Báscolo , E. ( 2018. ), “ Social determinants, conditions and performance of health services in Latin American countries, Portugal and Spain ”, Ciência and Saúde Coletiva , Vol. 23 No. 7 , pp. 2171 - 2186 . - PubMed