Psychology and Health Research Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
Ikerbasque Basque Foundation for Science, Bilbao, Spain.
J Health Organ Manag. 2021 Sep 2;ahead-of-print(ahead-of-print):349-67. doi: 10.1108/JHOM-12-2020-0512.
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.
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.
本研究旨在阐明与在西班牙巴斯克地区的基层医疗中心实施基于证据的健康促进干预措施相关的医疗保健组织、管理和政策障碍和促进因素。
设计/方法/方法：对参与“开出处方健康生活”项目的来自六个基层医疗中心的 49 名卫生专业人员进行了七次焦点小组讨论。使用实施研究综合框架（CFIR）分析文本，重点关注与医疗保健组织、管理和政策相关的结构。
发现健康促进干预措施与基层医疗专业人员的价值观相符。然而，所有中心的专业人员都报告了与实施相关的障碍，包括：（1）外部政策和激励措施，（2）与现有工作流程的兼容性，以及（3）开展项目的可用资源。这些领域的具体障碍与缺乏财务和政治支持、咨询时间限制以及难以管理日常竞争需求有关。其他障碍和促进因素与网络和沟通、文化、相对优先级和领导力参与等结构有关。出现了六组特定的障碍促进因素对。
原创性/价值：实施科学，特别是 CFIR 结构，被用作指导。确定了在基层医疗中实施健康促进计划的障碍和促进因素。医疗保健管理人员和政策制定者可以修改这些因素，以营造更有利的实施环境。这些因素应在实施前阶段和实施过程中进行适当监测，以确保将健康促进有效地纳入基层医疗环境。
