Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence
- PMID: 37434293
- PMCID: PMC10335778
- DOI: 10.1002/14651858.CD013603.pub2
Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence
Update in
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Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence.Cochrane Database Syst Rev. 2023 Jul 19;7(7):CD013603. doi: 10.1002/14651858.CD013603.pub3. Cochrane Database Syst Rev. 2023. PMID: 37466272 Free PMC article.
Abstract
Background: Primary healthcare (PHC) integration has been promoted globally as a tool for health sector reform and universal health coverage (UHC), especially in low-resource settings. However, for a range of reasons, implementation and impact remain variable. PHC integration, at its simplest, can be considered a way of delivering PHC services together that sometimes have been delivered as a series of separate or 'vertical' health programmes. Healthcare workers are known to shape the success of implementing reform interventions. Understanding healthcare worker perceptions and experiences of PHC integration can therefore provide insights into the role healthcare workers play in shaping implementation efforts and the impact of PHC integration. However, the heterogeneity of the evidence base complicates our understanding of their role in shaping the implementation, delivery, and impact of PHC integration, and the role of contextual factors influencing their responses.
Objectives: To map the qualitative literature on healthcare workers' perceptions and experiences of PHC integration to characterise the evidence base, with a view to better inform future syntheses on the topic.
Search methods: We used standard, extensive Cochrane search methods. The latest search date was 28 July 2020. We did not search for grey literature due to the many published records identified.
Selection criteria: We included studies with qualitative and mixed methods designs that reported on healthcare worker perceptions and experiences of PHC integration from any country. We excluded settings other than PHC and community-based health care, participants other than healthcare workers, and interventions broader than healthcare services. We used translation support from colleagues and Google Translate software to screen non-English records. Where translation was not feasible we categorised these records as studies awaiting classification.
Data collection and analysis: For data extraction, we used a customised data extraction form containing items developed using inductive and deductive approaches. We performed independent extraction in duplicate for a sample on 10% of studies allowed for sufficient agreement to be reached between review authors. We analysed extracted data quantitatively by counting the number of studies per indicator and converting these into proportions with additional qualitative descriptive information. Indicators included descriptions of study methods, country setting, intervention type, scope and strategies, implementing healthcare workers, and client target population.
Main results: The review included 184 studies for analysis based on 191 included papers. Most studies were published in the last 12 years, with a sharp increase in the last five years. Studies mostly employed methods with cross-sectional qualitative design (mainly interviews and focus group discussions), and few used longitudinal or ethnographic (or both) designs. Studies covered 37 countries, with close to an even split in the proportions of high-income countries (HICs) and low- and middle-income countries (LMICs). There were gaps in the geographical spread for both HICs and LMICs and some countries were more dominant, such as the USA for HICs, South Africa for middle-income countries, and Uganda for low-income countries. Methods were mainly cross-sectional observational studies with few longitudinal studies. A minority of studies used an analytical conceptual model to guide the design, implementation, and evaluation of the integration study. The main finding was the various levels of diversity found in the evidence base on PHC integration studies that examined healthcare workers' perceptions and experiences. The review identified six different configurations of health service streams that were being integrated and these were categorised as: mental and behavioural health; HIV, tuberculosis (TB) and sexual reproductive health; maternal, women, and child health; non-communicable diseases; and two broader categories, namely general PHC services, and allied and specialised services. Within the health streams, the review mapped the scope of the interventions as full or partial integration. The review mapped the use of three different integration strategies and categorised these as horizontal integration, service expansion, and service linkage strategies. The wide range of healthcare workers who participated in the implementation of integration interventions was mapped and these included policymakers, senior managers, middle and frontline managers, clinicians, allied healthcare professionals, lay healthcare workers, and health system support staff. We mapped the range of client target populations.
Authors' conclusions: This scoping review provides a systematic, descriptive overview of the heterogeneity in qualitative literature on healthcare workers' perceptions and experience of PHC integration, pointing to diversity with regard to country settings; study types; client populations; healthcare worker populations; and intervention focus, scope, and strategies. It would be important for researchers and decision-makers to understand how the diversity in PHC integration intervention design, implementation, and context may influence how healthcare workers shape PHC integration impact. The classification of studies on the various dimensions (e.g. integration focus, scope, strategy, and type of healthcare workers and client populations) can help researchers to navigate the way the literature varies and for specifying potential questions for future qualitative evidence syntheses.
배경: 1차 의료(PHC) 통합은 특히 자원이 부족한 환경에서 의료 부문 개혁 및 보편적 의료 보장(UHC)을 위한 도구로 전 세계적으로 추진되었다. 그러나 여러 가지 이유로 구현 및 영향은 가변적이다. PHC 통합은 가장 간단하게 일련의 개별 또는 '수직적' 건강 프로그램으로 제공되는 PHC 서비스를 함께 제공하는 방법으로 간주될 수 있다. 의료 종사자들은 개혁 중재의 성공을 형성하는 것으로 알려져 있다. 따라서 PHC 통합에 대한 의료 종사자의 인식과 경험을 이해하면 의료 종사자가 PHC 통합의 구현 노력과 영향을 형성하는 역할에 대한 통찰력을 얻을 수 있다. 그러나 근거 기반의 이질성은 PHC 통합의 구현, 전달 및 영향을 형성하는 역할과 응답에 영향을 미치는 상황적 요인의 역할에 대한 이해를 복잡하게 만듭니다. 목적: PHC 통합에 대한 의료 종사자의 인식과 경험에 대한 질적 문헌을 매핑하여 해당 주제에 대한 향후 합성에 더 나은 정보를 제공하기 위해 근거 기반을 특성화한다. 검색 전략: 표준적이고 광범위한 코크란 검색 방법을 사용했다. 최근 검색 날짜는 2020년 7월 28일이었다. 많은 출판된 기록이 확인되었기 때문에 회색 문헌을 검색하지 않았다. 선정 기준: 모든 국가의 PHC 통합에 대한 의료 종사자의 인식과 경험에 대해 보고한 정성적 및 혼합 방법 설계 연구를 포함했다. PHC 및 지역사회 기반 건강 관리 이외의 환경, 의료 종사자 이외의 참여자, 의료 서비스보다 광범위한 중재은 제외했다. 동료의 번역 지원과 Google 번역 소프트웨어를 사용하여 비영어 기록을 선별했다. 번역이 불가능할 경우 이러한 기록을 분류 대기 중인 연구로 분류했다. 자료 수집 및 분석: 데이터 추출을 위해 귀납적 접근과 연역적 접근을 사용하여 개발된 항목을 포함하는 맞춤형 데이터 추출 양식을 사용했다. 검토 저자 간에 충분한 합의에 도달할 수 있도록 허용된 연구의 10%에 대한 샘플에 대해 중복으로 독립적인 추출을 수행했다. 추출된 데이터는 지표별 연구 수를 세고 추가 정성적 설명 정보와 함께 비율로 변환하여 정량적으로 분석했다. 지표에는 연구 방법, 국가 설정, 중재 유형, 범위 및 전략, 의료 종사자 구현 및 고객 대상 인구에 대한 설명이 포함되었다. 주요 결과: 검토에는 191개의 포함된 논문을 기반으로 분석을 위한 184개의 연구가 포함되었다. 대부분의 연구는 지난 12년 동안 발표되었으며 지난 5년 동안 급격히 증가했다. 연구는 주로 단면적 질적 디자인(주로 인터뷰 및 포커스 그룹 토론)을 사용하는 방법을 사용했으며 종단적 또는 민족지학적(또는 둘 다) 디자인을 거의 사용하지 않았다. 연구는 고소득 국가(HIC)와 저소득 및 중간 소득 국가(LMIC)의 비율이 거의 균등하게 분할된 37개국을 대상으로 했다. HIC와 LMIC 모두 지리적 분포에 차이가 있었고 HIC의 경우 미국, 중간 소득 국가의 경우 남아프리카, 저소득 국가의 경우 우간다와 같은 일부 국가가 더 우세했다. 방법은 주로 종단 연구가 거의 없는 단면 관찰 연구였다. 소수의 연구는 통합 연구의 설계, 구현 및 평가를 안내하기 위해 분석적 개념 모델을 사용했다. 주요 발견은 의료 종사자의 인식과 경험을 조사한 PHC 통합 연구의 근거 기반에서 발견된 다양한 수준의 다양성이었다. 검토에서는 통합되고 있는 의료 서비스 흐름의 6가지 다른 구성을 식별했으며 이들은 다음과 같이 분류되었다. 정신 및 행동 건강; HIV, 결핵(TB) 및 성 생식 건강; 산모, 여성 및 어린이 건강; 비전염성 질병; 일반 PHC 서비스와 연합 및 전문 서비스라는 두 가지 더 넓은 범주가 있다. 건강 스트림 내에서 검토는 중재 범위를 전체 또는 부분 통합으로 매핑했다. 검토에서는 세 가지 통합 전략의 사용을 매핑하고 이를 수평 통합, 서비스 확장 및 서비스 연계 전략으로 분류했다. 통합 중재의 구현에 참여한 광범위한 의료 종사자들이 매핑되었으며 여기에는 정책 입안자, 고위 관리자, 중간 및 일선 관리자, 임상의, 연합 의료 전문가, 일반 의료 종사자 및 의료 시스템 지원 직원이 포함되었다. 고객 대상 집단의 범위를 매핑했다. 연구진 결론: 이 범위 검토는 국가 설정, 연구 유형, 고객 인구, 의료 종사자 인구, 그리고 중재 초점, 범위 및 전략에 관한 다양성을 지적하면서 PHC 통합에 대한 의료 종사자의 인식과 경험에 대한 질적 문헌의 이질성에 대한 체계적이고 설명적인 개요를 제공한다. 연구자와 의사 결정자는 PHC 통합 중재 설계, 구현 및 맥락의 다양성이 의료 종사자가 PHC 통합 영향을 형성하는 방식에 어떻게 영향을 미칠 수 있는지 이해하는 것이 중요하다. 다양한 차원(예: 통합 초점, 범위, 전략, 의료 종사자 및 고객 집단의 유형)에 대한 연구 분류는 연구자가 문헌이 다양한 방식을 탐색하고 미래의 질적 근거 합성에 대한 잠재적 질문을 지정하는 데 도움이 될 수 있다.
Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
HM: no financial conflict
KD: no financial conflict
CB‐S: no financial conflict
SC: no financial conflict
MT: no financial conflict
WO: no financial conflict
EA: no financial conflict
NL: no financial conflict
Several non‐financial issues, including personal, political, and academic factors, could have influenced the review authors' input when conducting this review. The review authors have discussed this further in the sections on reflexivity in the Methods section.
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Derrett 2014 {published data only}
Donnelly 2013 {published data only}
Douglas 2017 {published data only}
-
- Douglas HE, Georgiou A, Tariq A, Prgomet M, Warland A, Armour P, et al. Implementing information and communication technology to support community aged care service integration: lessons from an Australian aged care provider. International Journal of Integrated Care 2017;17(1):9. [DOI: 10.5334/ijic.2437] - DOI - PMC - PubMed
Duma 2019 {published data only}
Dunbar 2018 {published data only}
Edelman 2016 {published data only}
Fitzpatrick 2017 {published data only}
Fitzpatrick 2018 {published data only}
Fleury 2016 {published data only}
Fong 2019 {published data only}
Foster 2009 {published data only}
-
- Foster MM, Cornwell PL, Fleming JM, Mitchell GK, Tweedy SM, Hart AL, et al. Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners. Australian Journal of Primary Health 2009;15(4):326-34. [DOI: 10.1071/PY08065] - DOI
Foster 2016 {published data only}
-
- Foster M, Burridge L, Donald M, Zhang J, Jackson C. The work of local healthcare innovation: a qualitative study of GP-led integrated diabetes care in primary health care organization, structure and delivery of healthcare. BMC Health Services Research 2016;16:11. [DOI: 10.1186/s12913-016-1270-4] - DOI - PMC - PubMed
Gadomski 2014 {published data only}
-
- Gadomski AM, Wissow LS, Palinkas L, Hoagwood KE, Daly JM, Kaye DL. Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. General Hospital Psychiatry 2014;36(6):555-62. [DOI: 10.1016/j.genhosppsych.2014.05.013] - DOI - PMC - PubMed
Gavin 2008 {published data only}
Gear 2016 {published data only}
Geelhoed 2013 {published data only}
-
- Geelhoed D, Lafort Y, Chissale E, Candrinho B, Degomme O. Integrated maternal and child health services in Mozambique: structural health system limitations overshadow its effect on follow-up of HIV-exposed infants. BMC Health Services Research 2013;13:207. [DOI: 10.1186/1472-6963-13-207] - DOI - PMC - PubMed
Gerber 2018 {published data only}
Gerrish 1999 {published data only}
Ghorbani 2018 {published data only}
Glasgow 2012 {published data only}
-
- Glasgow RE, Kurz D, Dickman JM, Osuna D, Strycker L, King DK. Linking internet-based diabetes self-management to primary care: lessons learned and implications for research translation and practice implementation. Translational Behavioral Medicine 2012;2(3):313-21. [DOI: 10.1007/s13142-012-0109-8] - DOI - PMC - PubMed
Greene 2016 {published data only}
Gucciardi 2016 {published data only}
Gunn 2015 {published data only}
Haddow 2007 {published data only}
Harnagea 2018 {published data only}
Hepworth 2015 {published data only}
Hlongwa 2019 {published data only}
-
- Hlongwa EN, Sibiya MN. A practice framework to enhance the implementation of the Policy on Integration of Mental Health Care into primary health care in KwaZulu-Natal province. African Journal of Primary Health Care & Family Medicine 2019;11(1):e1-8. [DOI: 10.4102/phcfm.v11i1.1865] - DOI - PMC - PubMed
Hunter 2018 {published data only}
Ion 2017 {published data only}
Jacobs 2012 {published data only}
Jauregui 2016 {published data only}
Jewett 2013 {published data only}
Johnson 2020 {published data only}
-
- Johnson LC, Chwastiak L, Poongothai S, Tandon N, Anjana RM, Aravind S, et al. Adaptations and patient responses to behavioral intervention components in a depression-focused chronic disease care model implemented in India. Translational Behavioral Medicine 2020;10(1):35-45. [DOI: 10.1093/tbm/ibz192] - DOI - PMC - PubMed
Jorgenson 2014 {published data only}
Kawonga 2016 {published data only}
Khan 2018 {published data only}
Kirchner 2004 {published data only}
Lane 2017 {published data only}
Langer 2014 {published data only}
Lawn 2014 {published data only}
Limbani 2019 {published data only}
Lombard 2009 {published data only}
Lovero 2019 {published data only}
-
- Lovero KL, Lammie SL, Zyl A, Paul SN, Ngwepe P, Mootz JJ, et al. Mixed-methods evaluation of mental healthcare integration into tuberculosis and maternal-child healthcare services of four South African districts. BMC Health Services Research 2019;19(1):83. [DOI: 10.1186/s12913-019-3912-9] - DOI - PMC - PubMed
Lucas 2016 {published data only}
Ma 2018 {published data only}
Main 2007 {published data only}
-
- Main R, Dunn N, Kendall K. 'Crossing professional boundaries': barriers to the integration of nurse practitioners in primary care. Education for Primary Care 2007;18(4):480-7. [DOI: 10.1080/14739879.2007.11493578] - DOI
Malachowski 2019 {published data only}
Marais 2015 {published data only}
Martin 2018 {published data only}
-
- Martin SL, Wawire V, Ombunda H, Li T, Sklar K, Tzehaie H, et al. Integrating calcium supplementation into facility-based antenatal care services in western Kenya: a qualitative process evaluation to identify implementation barriers and facilitators. Current Developments in Nutrition 2018;2(11):nzy068. [DOI: 10.1093/cdn/nzy068] - DOI - PMC - PubMed
Mathibe 2015 {published data only}
Mayer 2016 {published data only}
-
- Mayer MK, Urlaub DM, Guzman-Corrales LM, Kowitt SD, Shea CM, Fisher EB. "They're doing something that actually no one else can do": a qualitative study of peer support and primary care integration. Journal of Ambulatory Care Management 2016;39(1):76-86. [DOI: 10.1097/JAC.0000000000000079] - DOI - PMC - PubMed
Mayhew 2017 {published data only}
-
- Mayhew SH, Sweeney S, Warren CE, Collumbien M, Ndwiga C, Mutemwa R, et al. Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya. Health Policy & Planning 2017;32(Suppl 4):iv67-81. [DOI: 10.1093/heapol/czx097] - DOI - PMC - PubMed
McGeehan 2007 {published data only}
McNamara 2020 {published data only}
-
- McNamara KP, Krass I, Peterson GM, Alzubaidi H, Grenfell R, Freedman B, et al. Implementing screening interventions in community pharmacy to promote interprofessional coordination of primary care – a mixed methods evaluation. Research In Social & Administrative Pharmacy 2020;16(2):160-7. [DOI: 10.1016/j.sapharm.2019.04.011] - DOI - PubMed
Meyer‐Kalos 2017 {published data only}
Miguel‐Esponda 2020 {published data only}
-
- Miguel-Esponda G, Bohm-Levine N, Rodríguez-Cuevas FG, Cohen A, Kakuma R. Implementation process and outcomes of a mental health programme integrated in primary care clinics in rural Mexico: a mixed-methods study. International Journal of Mental Health Systems 2020;14:21. [DOI: 10.1186/s13033-020-00346-x] - DOI - PMC - PubMed
Mishra 2014 {published data only}
Mugisha 2016 {published data only}
Mulenga 2019 {published data only}
-
- Mulenga P, Boelaert M, Lutumba P, Vander Kelen C, Coppieters Y, Chenge F, et al. Integration of human African trypanosomiasis control activities into primary health services in the Democratic Republic of the Congo: a qualitative study of stakeholder perceptions. American Journal of Tropical Medicine & Hygiene 2019;100(4):899-906. [DOI: 10.4269/ajtmh.18-0382] - DOI - PMC - PubMed
Murphy 2018 {published data only}
Mutabazi 2020 {published data only}
-
- Mutabazi JC, Gray C, Muhwava L, Trottier H, Ware LJ, Norris S, et al. Integrating the prevention of mother-to-child transmission of HIV into primary healthcare services after AIDS denialism in South Africa: perspectives of experts and health care workers – a qualitative study. BMC Health Services Research 2020;20(1):582. [DOI: 10.1186/s12913-020-05381-5] - DOI - PMC - PubMed
Mutemwa 2013 {published data only}
Mykhalovskiy 2009 {published data only}
-
- Mykhalovskiy E, Patten S, Sanders C, Bailey M, Taylor D. Conceptualizing the integration of HIV treatment and prevention: findings from a process evaluation of a community-based, national capacity-building intervention. International Journal of Public Health 2009;54(3):133-41. [DOI: 10.1007/s00038-009-8078-5] - DOI - PubMed
Ndwiga 2014 {published data only}
-
- Ndwiga C, Abuya T, Mutemwa R, Kimani JK, Colombini M, Mayhew S, et al, Integra Initiative. Exploring experiences in peer mentoring as a strategy for capacity building in sexual reproductive health and HIV service integration in Kenya. BMC Health Services Research 2014;14:98. [DOI: 10.1186/1472-6963-14-98] - DOI - PMC - PubMed
Nelson 2019 {published data only}
-
- Nelson AR, Cooper CM, Kamara S, Taylor ND, Zikeh T, Kanneh-Kesselly C, et al. Operationalizing integrated immunization and family planning services in rural Liberia: lessons learned from evaluating service quality and utilization. Global Health Science & Practice 2019;7(3):418-34. [DOI: 10.9745/GHSP-D-19-00012] - DOI - PMC - PubMed
Newell 2018 {published data only}
-
- Newell E, Donnell MO. Integrated care: a qualitative study exploring GPs' and practice nurses' experiences of working with the diabetes nurse specialist. Journal of Diabetes Nursing 2018;22(6):46.
Newmann 2013 {published data only}
Newmann 2016 {published data only}
Nooteboom 2020 {published data only}
-
- Nooteboom LA, den Driesschen SI, Kuiper CH, Vermeiren Rrjm, Mulder EA. An integrated approach to meet the needs of high-vulnerable families: a qualitative study on integrated care from a professional perspective. Child and Adolescent Psychiatry and Mental Health 2020;14:18. [DOI: 10.1186/s13034-020-00321-x] - DOI - PMC - PubMed
Norfleet 2016 {published data only}
Nxumalo 2013 {published data only}
Oishi 2003 {published data only}
-
- Oishi SM, Shoai R, Katon W, Callahan C, Unutzer J, Arean P, et al, Improving Mood: Promoting Access to Collaborative Treatment Investigators. Impacting late life depression: integrating a depression intervention into primary care. Psychiatric Quarterly 2003;74(1):75-89. [DOI: 10.1023/A:1021197807029] - DOI - PubMed
Ojikutu 2014 {published data only}
Okot‐Chono 2009 {published data only}
-
- Okot-Chono R, Mugisha F, Adatu F, Madraa E, Dlodlo R, Fujiwara P. Health system barriers affecting the implementation of collaborative TB-HIV services in Uganda. International Journal of Tuberculosis and Lung Disease 2009;13(8):955-61. - PubMed
Oliff 2003 {published data only}
Patwa 2019 {published data only}
Payne 2017 {published data only}
Peer 2020 {published data only}
Pereira 2011 {published data only}
-
- Pereira B, Andrew G, Pednekar S, Kirkwood BR, Patel V. The integration of the treatment for common mental disorders in primary care: experiences of health care providers in the MANAS trial in Goa, India. International Journal of Mental Health Systems 2011;5(1):26. [DOI: 10.1186/1752-4458-5-26] - DOI - PMC - PubMed
Petersen 2009 {published data only}
-
- Petersen I, Bhana A, Campbell-Hall V, Mjadu S, Lund C, Kleintjies S, et al, Mental Health and Poverty Research Programme Consortium. Planning for district mental health services in South Africa: a situational analysis of a rural district site. Health Policy & Planning 2009;24(2):140-50. [DOI: 10.1093/heapol/czn049] - DOI - PubMed
Petersen 2011 {published data only}
Petersen 2019 {published data only}
Pfitzer 2019 {published data only}
-
- Pfitzer A, Maly C, Tappis H, Kabue M, Mackenzie D, Healy S, et al. Characteristics of successful integrated family planning and maternal and child health services: findings from a mixed-method, descriptive evaluation. F1000Research 2019;8:229. [DOI: 10.12688/f1000research.17208.2] - DOI - PMC - PubMed
Pidano 2011 {published data only}
Piper 2018 {published data only}
Piper 2020 {published data only}
Porter 2002 {published data only}
-
- Porter JD, Ogden JA, Rao PV, Rao VP, Rajesh D, Buskade RA, et al. Lessons in integration--operations research in an Indian leprosy NGO. Leprosy Review 2002;73(2):147-59. - PubMed
Ramanuj 2018 {published data only}
-
- Ramanuj PP, Talley R, Breslau J, Wang SS, Pincus HA. Integrating behavioral health and primary care services for people with serious mental illness: a qualitative systems analysis of integration in New York. Community Mental Health Journal 2018;54(8):1116-26. [DOI: 10.1007/s10597-018-0251-y] - DOI - PMC - PubMed
Reinschmidt 2017 {published data only}
-
- Reinschmidt KM, Ingram M, Morales S, Sabo SJ, Blackburn J, Murrieta L, et al. Documenting community health worker roles in primary care: contributions to evidence-based integration into health care teams, 2015. Journal of Ambulatory Care Management 2017;40(4):305-15. [DOI: 10.1097/JAC.0000000000000178] - DOI - PubMed
Rissi 2015 {published data only}
Robertson 2018 {published data only}
Rodriguez 2006 {published data only}
Rodriguez 2019 {published data only}
-
- Rodriguez EM, Gulbas LE, George-Jones J, Leija A, Burrows D, Neavel C. Interdisciplinary perspectives on an integrated behavioral health model of psychiatry in pediatric primary care: a community-based participatory research study. Community Mental Health Journal 2019;55(4):569-77. [DOI: 10.1007/s10597-018-0330-0] - DOI - PubMed
Rojas 2015 {published data only}
Ross 2000 {published data only}
-
- Ross F, Rink E, Furne A. Integration or pragmatic coalition? An evaluation of nursing teams in primary care. Journal of Interprofessional Care 2000;14(3):259-67. [DOI: 10.1080/jic.14.3.259.267] - DOI
Ryman 2012b {published data only}
-
- Ryman TK, Wallace A, Mihigo R, Richards P, Schlanger K, Cappelier K, et al. Community and health worker perceptions and preferences regarding integration of other health services with routine vaccinations: four case studies. Journal of Infectious Diseases 2012;205(Suppl 1):S49-55. [DOI: 10.1093/infdis/jir796] - DOI - PubMed
Ryman 2012c {published data only}
Sakeah 2014 {published data only}
-
- Sakeah E, McCloskey L, Bernstein J, Yeboah-Antwi K, Mills S, Doctor HV. Can community health officer-midwives effectively integrate skilled birth attendance in the community-based health planning and services program in rural Ghana? Reproductive Health 2014;11:90. [DOI: 10.1186/1742-4755-11-90] - DOI - PMC - PubMed
Savickas 2020 {published data only}
Shattell 2011 {published data only}
-
- Shattell MM, Donnelly N, Scheyett A, Cuddeback GS. Assertive community treatment and the physical health needs of persons with severe mental illness: issues around integration of mental health and physical health. Journal of the American Psychiatric Nurses Association 2011;17(1):57-63. [DOI: 10.1177/1078390310393737] - DOI - PubMed
Shelley 2019 {published data only}
-
- Shelley KD, Frumence G, Mpembeni R, Mwinnyaa G, Joachim J, Kisusi HK, et al. "Because even the person living with HIV/AIDS might need to make babies" – perspectives on the drivers of feasibility and acceptability of an integrated community health worker model in Iringa, Tanzania. International Journal of Health Policy & Management 2019;8(9):538-49. [DOI: 10.15171/ijhpm.2019.38] - DOI - PMC - PubMed
Sheth 2020 {published data only}
-
- Sheth AN, Hussen SA, Escoffery C, Haddad LB, Powell L, Brown N, et al. Pre-exposure prophylaxis integration into family planning services at Title X Clinics in the Southeastern United States: protocol for a mixed methods hybrid type I effectiveness implementation study (Phase 2 ATN 155). JMIR Research Protocol 2020;9(9):e18784. [DOI: 10.2196/18784] - DOI - PMC - PubMed
Shin 2018 {published data only}
Shrivastava 2020a {published data only}
-
- Shrivastava R, Couturier Y, Girard F, Bedos C, Macdonald ME, Torrie J, et al. Appreciative inquiry in evaluating integrated primary oral health services in Quebec Cree communities: a qualitative multiple case study. Dentistry and Oral Medicine 2020;10(6):e038164. [DOI: 10.1136/bmjopen-2020-038164] - DOI - PMC - PubMed
Shrivastava 2020b {published data only}
-
- Shrivastava R, Campeau R, Couturier Y, Torrie J, Girard F, Marie-Pierre B, et al. Anthropological perspectives on Miyupimaatisiiun and the integration of oral health in primary care in the Cree communities of Northern Quebec. PLOS One 2020;15(4):e0231406. [DOI: 10.1371/journal.pone.0231406] - DOI - PMC - PubMed
Siantz 2018 {published data only}
Sieverding 2016 {published data only}
Sinai 2018 {published data only}
Smit 2012 {published data only}
-
- Smit JA, Church K, Milford C, Harrison AD, Beksinska ME. Key informant perspectives on policy- and service-level challenges and opportunities for delivering integrated sexual and reproductive health and HIV care in South Africa. BMC Health Services Research 2012;12:48. [DOI: 10.1186/1472-6963-12-48] - DOI - PMC - PubMed
Sobo 2008 {published data only}
-
- Sobo EJ, Bowman C, Halloran J, Asch SM, Goetz MB, Gifford AL. 'A routine thing': clinician strategies for implementing HIV testing for at-risk patients in a busy healthcare organisation (and implications for implementation of other new practice recommendations). Anthropology & Medicine 2008;15(3):213-25. [DOI: 10.1080/13648470802357489] - DOI - PubMed
Souza 2019 {published data only}
Souza Gleriano 2019 {published data only}
-
- Souza Gleriano J, da Luz Zaiaz PC, Pereira Borges A, Lucietto GC, Balderrama P, Almeida Corrêa CR, et al. Integral care in the perception of family health strategy professionals. Journal of Nursing 2019;13:1170-8. [DOI: 10.5205/1981-8963.2019.242241] - DOI
Ssebunnya 2010 {published data only}
Stadnick 2020 {published data only}
Surjaningrum 2018 {published data only}
-
- Surjaningrum ER, Minas H, Jorm AF, Kakuma R. The feasibility of a role for community health workers in integrated mental health care for perinatal depression: a qualitative study from Surabaya, Indonesia. International Journal of Mental Health Systems 2018;12(31):27. [DOI: 10.1186/s13033-018-0208-0] - DOI - PMC - PubMed
Tai‐Seale 2010 {published data only}
Terry 2018 {published data only}
-
- Terry V, Sandoval A, Garza J, Lowdermilk J, Lerma E, Lapka S, et al. What drives members of an interprofessional care team: a sense of self. Journal of Interprofessional Education and Practice 2018;13:27-32. [DOI: 10.1016/j.xjep.2018.08.009] - DOI
Topp 2010 {published data only}
-
- Topp SM, Chipukuma JM, Giganti M, Mwango LK, Chiko LM, Tambatamba-Chapula B, et al. Strengthening health systems at facility-level: feasibility of integrating antiretroviral therapy into primary health care services in Lusaka, Zambia. PLOS One 2010;5(7):e11522. [DOI: 10.1371/journal.pone.0011522] - DOI - PMC - PubMed
Topp 2013 {published data only}
Treloar 2014 {published data only}
Tsasis 2012 {published data only}
Tshililo 2019 {published data only}
-
- Tshililo AR, Mangena-Netshikweta L, Nemathaga LH, Maluleke M. Challenges of primary healthcare nurses regarding the integration of HIV and AIDS services into primary healthcare in Vhembe district of Limpopo province, South Africa. Curationis 2019;42(1):e1-6. [DOI: 10.4102/curationis.v42i1.1849] - DOI - PMC - PubMed
Tsui 2018 {published data only}
-
- Tsui J, Hudson SV, Rubinstein EB, Howard J, Hicks E, Kieber-Emmons A, et al. A mixed-methods analysis of the capacity of the Patient-Centered Medical Home to implement care coordination services for cancer survivors. Translational Behavioral Medicine 2018;8(3):319-27. [DOI: 10.1093/tbm/ibx059] - DOI - PMC - PubMed
Uebel 2013 {published data only}
Urada 2014 {published data only}
Uwimana 2013 {published data only}
Venables 2016 {published data only}
-
- Venables E, Edwards JK, Baert S, Etienne W, Khabala K, Bygrave H. "They just come, pick and go." The acceptability of integrated medication adherence clubs for HIV and non communicable disease (NCD) patients in Kibera, Kenya. PLOS One 2016;11(10):e0164634. [DOI: 10.1371/journal.pone.0164634] - DOI - PMC - PubMed
Venancio 2016 {published data only}
-
- Venancio SI, da Costa Rosa TE, Sanches Bersusa AA. Comprehensive care to hypertension and diabetes mellitus: implementation of the Care Line in a Health Region of São Paulo, Brazil [Atenção integral à hipertensão arterial e diabetes mellitus: implementação da Linha de Cuidado em uma Região de Saúde do estado de São Paulo, Brasil]. Physis 2016;26(1):113-35. [DOI: 10.1590/S0103-73312016000100008] - DOI
Vestjens 2018 {published data only}
Vickers 2013 {published data only}
-
- Vickers KS, Ridgeway JL, Hathaway JC, Egginton JS, Kaderlik AB, Katzelnick DJ. Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access. General Hospital Psychiatry 2013;35(5):461-7. [DOI: 10.1016/j.genhosppsych.2013.06.011] - DOI - PubMed
Wakida 2018 {published data only}
-
- Wakida EK, Obua C, Rukundo GZ, Maling S, Talib ZM, Okello ES. Barriers and facilitators to the integration of mental health services into primary healthcare: a qualitative study among Ugandan primary care providers using the COM-B framework. BMC Health Services Research 2018;18(1):890. [DOI: 10.1186/s12913-018-3684-7] - DOI - PMC - PubMed
Wakida 2019 {published data only}
-
- Wakida EK, Okello ES, Rukundo GZ, Akena D, Alele PE, Talib ZM, et al. Health system constraints in integrating mental health services into primary healthcare in rural Uganda: perspectives of primary care providers. International Journal of Mental Health Systems 2019;13:16. [DOI: 10.1186/s13033-019-0272-0] - DOI - PMC - PubMed
Wallace 2013 {published data only}
Wallace 2014 {published data only}
-
- Wallace A, Kimambo S, Dafrossa L, Rusibamayila N, Rwebembera A, Songoro J, et al. Qualitative assessment of the integration of HIV services with infant routine immunization visits in Tanzania. Journal of Acquired Immune Deficiency Syndromes 2014;66(1):e8-14. [DOI: 10.1097/QAI.0000000000000078] - DOI - PMC - PubMed
Waterworth 2015 {published data only}
-
- Waterworth C, Willcocks S, Selfe J, Roddam H. Implementing care aims in an integrated team. British Journal of Healthcare Management 2015;21(1):36-45. [DOI: 10.12968/bjhc.2015.21.1.36] - DOI
Wener 2016 {published data only}
Wiese 2011 {published data only}
-
- Wiese M, Jolley G, Baum F, Freeman T, Kidd M. Australia's systems of primary healthcare – the need for improved coordination and implications for Medicare locals. Australian Family Physician 2011;40(12):995-9. - PubMed
Wilunda 2017 {published data only}
Yessimov 2019 {published data only}
-
- Yessimov N, Aringazina A, Tokmurziyeva G, Izmailova N, Seidumanov D. Assessment of the integration between primary health care and public health in Almaty. Research Journal of Pharmacy and Technology 2019;12(9):4241-9. [DOI: 10.5958/0974-360X.2019.00729.7] - DOI
Young 2019 {published data only}
-
- Young N, Achieng F, Desai M, Phillips-Howard P, Hill J, Aol G, et al. Integrated point-of-care testing (POCT) for HIV, syphilis, malaria and anaemia at antenatal facilities in western Kenya: a qualitative study exploring end-users' perspectives of appropriateness, acceptability and feasibility. BMC Health Services Research 2019;19(1):74. [DOI: 10.1186/s12913-018-3844-9] - DOI - PMC - PubMed
Zimbudzi 2019 {published data only}
-
- Zimbudzi E, Lo C, Robinson T, Ranasinha S, Teede HJ, Usherwood T, et al. The impact of an integrated diabetes and kidney service on patients, primary and specialist health professionals in Australia: a qualitative study. PLOS One 2019;14(7):e0219685. [DOI: 10.1371/journal.pone.0219685] - DOI - PMC - PubMed
Zotti 2010 {published data only}
Zulu 2015 {published data only}
Zulu 2019 {published data only}
-
- Zulu JM, Kinsman J, Hurtig AK, Michelo C, George A, Schneider H. Integrating community health assistant-driven sexual and reproductive health services in the community health system in Nyimba district in Zambia: mapping key actors, points of integration, and conditions shaping the process. Reproductive Health 2019;16(1):122. [DOI: 10.1186/s12978-019-0788-4] - DOI - PMC - PubMed
References to studies excluded from this review
Adeokun 2002 {published data only}
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- Adeokun L, Mantell JE, Weiss E, Delano GE, Jagha T, Olatoregun J, et al. Promoting dual protection in family planning clinics in Ibadan, Nigeria. International Family Planning Perspectives 2002;28(2):87-95. [DOI: 10.2307/3088240] - DOI
Aguirre 2013 {published data only}
Aguirre‐Duarte 2015 {published data only}
Ahmed 2015 {published data only}
Almeida 2018 {published data only}
Altabaibeh 2020 {published data only}
Anastas 2019 {published data only}
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- Anastas T, Needham Waddell E, Howk S, Remiker M, Horton-Dunbar G, Fagnan LJ. Building behavioral health homes: clinician and staff perspectives on creating integrated care teams. Journal of Behavioral Health Services & Research 2019;46(3):475-86. [DOI: 10.1007/s11414-018-9622-y] - DOI - PMC - PubMed
Anderson 2016 {published data only}
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- Anderson K, Bird M, Blair A, MacPherson S. Development and effectiveness of an integrated inpatient and community service for challenging behaviour in late life: from confused and disturbed elderly to transitional behavioural assessment and intervention service. Dementia 2016;15(6):1340-57. [DOI: 10.1177/1471301214559106] - DOI - PubMed
Angus 2018 {published data only}
Antunes 2019 {published data only}
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- Antunes A, Frasquilho D, Zózimo JR, Silva M, Cardoso G, Ferrão J, et al. Solutions to tackle the mental health consequences of the economic recession: a qualitative study integrating primary health care users and professionals' perspectives. Health Policy 2019;123(12):1267-74. [DOI: 10.1016/j.healthpol.2019.10.003] - DOI - PubMed
Atchison 2018 {published data only}
Au 2018 {published data only}
Aufegger 2020 {published data only}
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- Aufegger L, Alabi M, Darzi A, Bicknell C. Sharing leadership: current attitudes, barriers and needs of clinical and non-clinical managers in UK's integrated care system. BMJ Leader 2020;4:128-34. [DOI: 10.1136/leader-2020-000228] - DOI
Aune 2014 {published data only}
Ayangade 1984 {published data only}
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- Ayangade O. Integrated family planning services: a Nigerian experience. East African Medical Journal 1984;61(5):412-9. [PMID: ] - PubMed
Bagayogo 2018 {published data only}
Bajorek 2015 {published data only}
Balira 2015 {published data only}
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- Balira R, Mabey D, Weiss H, Ross DA, Changalucha J, Watson-Jones D. The need for further integration of services to prevent mother-to-child transmission of HIV and syphilis in Mwanza City, Tanzania. International Journal of Gynaecology & Obstetrics 2015;130(Suppl 1):S51-7. [DOI: 10.1016/j.ijgo.2015.04.016] - DOI - PubMed
Baltaxe 2019 {published data only}
Barchi 2009 {published data only}
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- Barchi D. Making healthcare delivery personal. Biomedical Instrumentation and Technology 2009;43(3):197-8. - PubMed
Barclay 2019 {published data only}
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- Barclay L, Lalor A, Migliorini C, Robins L. A comparative examination of models of service delivery intended to support community integration in the immediate period following inpatient rehabilitation for spinal cord injury. Spinal Cord 2019;58(5):528-36. [DOI: 10.1038/s41393-019-0394-x] - DOI - PubMed
Bardwell 2019 {published data only}
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- Bardwell G, Strike C, Mitra S, Scheim A, Barnaby L, Altenberg J, et al. "That's a double-edged sword": exploring the integration of supervised consumption services within community health centres in Toronto, Canada. Health and Place 2019;61:102245. [DOI: 10.1016/j.healthplace.2019.102245] - DOI - PubMed
Barraclough 2016 {published data only}
Barros 2019 {published data only}
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- Barros S, Nóbrega MD, Santos JC, Fonseca LM, Floriano LS. Mental health in primary health care: health-disease according to health professionals [La salud mental en la atención primaria: el proceso salud-Enfermedad, según los profesionales de la salud]. Revista Brasileira de Enfermagem 2019;72(6):1609-17. [DOI: 10.1590/0034-7167-2018-0743] - DOI - PubMed
Bauman 2013 {published data only}
Baxter 2002 {published data only}
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- Baxter C, Levin R, Legaspi MM, Bailey BE, Brown CL. Community health center-led networks: cooperating to compete. Journal of Healthcare Management 2002;46(6):376-88. - PubMed
Baxter 2009 {published data only}
Benzer 2015 {published data only}
Berenson 2016 {published data only}
Bergmark 2018 {published data only}
Bertrand 2010 {published data only}
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- Bertrand SW. Inroads to integrative health care: registered nurses' personal use of traditional Chinese medicine affects professional identity and nursing practice. Complementary Health Practice Review 2010;15(1):14-30. [DOI: 10.1177/1533210110374639] - DOI
Bhattacharyya 2016 {published data only}
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- Bhattacharyya O, Schull M, Shojania K, Stergiopoulos V, Naglie G, Webster F, et al. Building Bridges to Integrate Care (BRIDGES): incubating health service innovation across the continuum of care for patients with multiple chronic conditions. Healthcare Quarterly 2016;19(2):60-6. [DOI: 10.12927/hcq.2016.24701] - DOI - PubMed
Blakey 2014 {published data only}
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- Blakey JM, Bowers PH. Barriers to integrated treatment of substance abuse and trauma among women. Journal of Social Work Practice in the Addictions 2014;14(3):250-72. [DOI: 10.1080/1533256X.2014.933731] - DOI
Boehmer 2019 {published data only}
Bourgeault 2000 {published data only}
-
- Bourgeault IL. Delivering the 'new' Canadian midwifery: the impact on midwifery of integration into the Ontario health care system. Journal of Sociology of Health & Illness 2000;22(2):172-96.
Bracey 2010 {published data only}
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- Bracey T. Bournemouth, Dorset and Poole Total Place pilot: services and support for older people. Working with Older People 2010;14(2):31-7. [DOI: 10.5042/wwop.2010.0265] - DOI
Brant 2020 {published data only}
Brechat 2018 {published data only}
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- Brechat PH, Rasmusson K, Briot P, Foury C, Fulton R, Smith D, et al. Benefits of integrated care delivery system for heart failure: a case study of Intermountain Healthcare (USA) [Bénéfices de la prise en charge intégrée de l'insuffisance cardiaque: l'exemple d'Intermountain Healthcare (États-Unis)]. Sante Publique 2018;30(6):877-85. [DOI: 10.3917/spub.187.0877] - DOI - PubMed
Breton 2019 {published data only}
Brindis 2005 {published data only}
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- Brindis CD, Loo VS, Adler NE, Bolan GA, Wasserheit JN. Service integration and teen friendliness in practice: a program assessment of sexual and reproductive health services for adolescents. Journal of Adolescent Health 2005;37(2):155-62. [DOI: ] - PubMed
Briones‐Vozmediano 2018 {published data only}
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- Briones-Vozmediano E, Maquibar A, Vives-Cases C, Öhman A, Hurtig A-K, Goicolea I. Health-sector responses to intimate partner violence: fitting the response into the biomedical health system or adapting the system to meet the response? Journal of Interpersonal Violence 2018;33(10):1653-78. [DOI: 10.1177/0886260515619170] - DOI - PubMed
Brook 2017 {published data only}
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- Brook J, Salmon D, Knight RA. Preparing the sexual health workforce to deliver integrated services: is education the answer? A qualitative study exploring the impact of sexual health education on developing integrated policy and practice. Primary Health Care Research & Development 2017;18(3):270-81. [DOI: 10.1017/S1463423617000123] - DOI - PubMed
Brousselle 2010 {published data only}
Byrne 2019 {published data only}
Carroll 2018 {published data only}
Cash‐Gibson 2014 {published data only}
Catalao 2018 {published data only}
Chubak 2012 {published data only}
Coelho 2018 {published data only}
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- Coelho LP, Motta LB da, Caldas CP. Elderly care network: facilitating factors and barriers to implementation [Rede de atenção ao idoso: fatores facilitadores e barreiras para implementação]. Physis 2018;28(4):e280404. [DOI: 10.1590/S0103-73312018280404] - DOI
Contandriopoulos 2015 {published data only}
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- Contandriopoulos D, Brousselle A, Dubois CA, Perroux M, Beaulieu MD, Brault I, et al. A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis. BMC Health Services Research 2015;15(1):78. [DOI: 10.1186/s12913-015-0731-5] - DOI - PMC - PubMed
Cooper 2015 {published data only}
Correa 2018 {published data only}
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- Correa VA, Acioli S, Tinoco TF. The care of nurses in the Family Health Strategy: practices and theoretical foundation [Cuidado del enfermero en la Estrategia de Salud Familiar: prácticas y fundaciones teóricas]. Revista Brasileira de Enfermagem 2018;71(Suppl 6):2767-74. [DOI: 10.1590/0034-7167-2018-0383] - DOI - PubMed
DeBoer 2019 {published data only}
Dhondt 2017 {published data only}
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- Dhondt S, Hermans K, Molema H, Boermans S, Klauw D, Vrijhoef Hubertus JM. Mechanisms of integrated care in Flanders: a bottom-up perspective. International Journal of Care Coordination 2017;20(3):87-97. [DOI: 10.1177/2053434517734464] - DOI
Duffy 2017 {published data only}
Evans 2016 {published data only}
Fernandes 2014 {published data only}
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- Fernandes RZ, Vilela MF. Strategies for integration of health care practices and sanitary surveillance in the context of the implementation of Rede Cegonha – a Brazilian mother and infant health care network [Estratégias de integração das práticas assistenciais de saúde e de vigilância sanitária no contexto de implementação da Rede Cegonha]. Ciênc Saúde Coletiva 2014;19(11):4457-66. [DOI: 10.1590/1413-812320141911.21662013] - DOI - PubMed
Freeman 2012 {published data only}
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- Freeman C, Cottrell WN, Kyle G, Williams I, Nissen L. Integrating a pharmacist into the general practice environment: opinions of pharmacist's, general practitioner's, health care consumer's, and practice manager's. BMC Health Services Research 2012;12:229. [DOI: 10.1186/1472-6963-12-229] - DOI - PMC - PubMed
French 2006 {published data only}
Hallberg 2005 {published data only}
Henao‐Martinez 2008 {published data only}
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- Henao-Martinez D, Vazquez-Navarrete ML, Vargas-Lorenzo I, Coderch-Lassaletta J, Llopart-Lopez JR. Integral health provision by two Catalonian health providing entities (Spain) [Integración Asistencial de Dos Organizaciones en Cataluña, España]. Revista de Salud Publica 2008;10(1):33-48. - PubMed
Ingram 2019 {published data only}
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- Ingram M, Denman CA, Cornejo-Vucovich E, Castro-Vasquez MDC, Aceves B, Ocejo AG, et al. The Meta Salud Diabetes Implementation Study: qualitative methods to assess integration of a health promotion intervention into primary care to reduce CVD risk among an underserved population with diabetes in Sonora, Mexico. Frontiers in Public Health 2019;7:347. [DOI: 10.3389/fpubh.2019.00347] - DOI - PMC - PubMed
Kaehne 2016 {published data only}
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- Kaehne A. The Healthy Liverpool Children's Programme. Journal of Integrated Care 2016;24(3):124-38. [DOI: 10.1108/JICA-03-2016-0014] - DOI
References to studies awaiting assessment
Amelung 2015 {published data only}
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- Amelung V, Wolf S, Ozegowski S, Eble S, Hildebrandt H, Knieps F, et al. Declared dead? Recommendations regarding integrated care from the perspective of German statutory health insurance [Totgesagte leben länger: Empfehlungen zur Integrierten Versorgung aus Sicht der gesetzlichen Krankenkassen]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2015;58(4-5):352-9. - PubMed
Aoki 2017 {published data only}
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- Aoki M, Perez Batista MP, Morgani de Almeida MH, Molini-Avejonas DR, Corrêa Oliver F. Challenges on network care considering the perceptions of preceptors of a Pet-Network regarding people with disabilities and at-risk infants: access, comprehensiveness and communication. Cadernos Brasileiros de Terapia Ocupacional [Brazilian Journal of Occupational Therapy] 2017;25(3):519-32.
da Silva Bastos 2011 {published data only}
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- da Silva Bastos L, Araújo Assis MM, Alves do Nascimento MA, Feltrin de Oliveira LC. Integrality-building in the care of people with diabetes mellitus in a healthcare unit of Feira de Santana, Bahia State [Construção da integralidade no cuidar de pessoas com diabetes mellitus em um centro de saúde em Feira de Santana (BA)]. Ciência & Saúde Coletiva 2011;16(Suppl 1):1417-26. - PubMed
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- Kondo J, Onishi H, Greiner C. Rewarding, positive aspects and nursing characteristics of comprehensive community care practices by clinic nurses. An Official Journal of the Japan Primary Care Association 2014;1(1):10-5.
Rodrigues 2010 {published data only}
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- Rodrigues Arce VA, De Sousa MF, da Glória Lima M. Mental health praxis within the family health strategy: contributions to build an integrated care. Physis 2010;21(2):541-60. [DOI: 10.1590/S0103-73312011000200011] - DOI
Ruppert 2017 {published data only}
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- Ruppert D, Stegbauer C, Bramesfeld A, Bestmann B, Szecsenyi J, Götz K. "Hope Dies Last …" – cross-sectoral cooperation in integrated care: a qualitative study. Psychiatrische Praxis 2017;44(3):134-40. - PubMed
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- Santos FA, Carvalho de Sousa IM, Dantas Gurgel ID, Benjamin Bezerra AF, Barros NF. Policy of integrative practices in Recife (Northeastern Brazil): analysis of the participation of the actors [Política de práticas integrativas em Recife: análise da participação dos atores]. Revista de Saúde Pública 2011;45(6):1154-9. - PubMed
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References to ongoing studies
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