Clet Estelle, Essilini Anais, Cornet Céleste, Joseph Jean-Philippe, Cohidon Christine, Alla François
Department of Preventive Medicine, University Hospital of Bordeaux, Bordeaux, F-33000, France.
University of Bordeaux, INSERM, BPH, U1219, I-Prev/PHARES, CIC 1401, Bordeaux, F-33000, France.
BMC Prim Care. 2025 May 10;26(1):152. doi: 10.1186/s12875-025-02849-3.
Although primary care providers have a major role to play in combating risk factors, preventive practices can still be improved. The development of coordinated practice is considered as an opportunity to integrate prevention into primary care. What are the conditions, obstacles and facilitators involved in such a process?
To explore and describe the conditions under which prevention is integrated into 'communautés professionnelles territoriales de santé' (CPTS = territorial professional health communities) in France, a new type of primary care organization being generalized in France.
A case study was conducted in two regions of France. We conducted interviews with: (i) healthcare professionals and coordinators, and (ii) local healthcare authorities and territorial officers for the CPTS. Data were collected through individual and semi-structured group interviews, observations and a documentary analysis. They were then coded by two investigators according to two coding trees depending on the population involved. A thematic analysis was then carried out.
This case study was composed of 18 interviews, two observations and three documents. They showed that healthcare professionals and healthcare authorities do not share the same vision, issues and expectations regarding prevention. For the former, prevention should be integrated into care as in preventive clinical practices, while the latter are more focused on the healthcare system with a vision based on prevention programs.
This study identified the obstacles and facilitators to integrating prevention into coordinated practices in primary care.
尽管初级保健提供者在应对风险因素方面发挥着重要作用，但预防措施仍有改进空间。发展协调医疗实践被视为将预防融入初级保健的一个契机。这一过程涉及哪些条件、障碍和促进因素？
探讨并描述在法国将预防措施融入“地域专业健康社区”（CPTS）的条件，CPTS是法国正在推广的一种新型初级保健组织形式。
在法国的两个地区开展了一项案例研究。我们对以下人员进行了访谈：（i）医疗保健专业人员和协调员，以及（ii）CPTS的地方卫生当局和地区官员。通过个人和半结构化小组访谈、观察以及文献分析收集数据。然后由两名研究人员根据涉及的人群，按照两棵编码树对数据进行编码。随后进行了主题分析。
该案例研究包括18次访谈、两次观察和三份文件。结果显示，医疗保健专业人员和卫生当局在预防方面的愿景、问题和期望并不相同。对于前者而言，预防应像在预防性临床实践中那样融入医疗服务，而后者则更关注基于预防项目愿景的医疗保健系统。
本研究确定了将预防融入初级保健协调医疗实践的障碍和促进因素。
