Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2008

Open Access 01-12-2008 | Research article

Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers

Authors: Gonzalo Grandes, Alvaro Sanchez, Josep M Cortada, Laura Balague, Carlos Calderon, Arantza Arrazola, Itziar Vergara, Eduardo Millan, the "Prescribe Vida Saludable" group

Published in: BMC Health Services Research | Issue 1/2008

Login to get access

Abstract

Background

The adoption of a healthy lifestyle, including physical activity, a healthy diet, moderate alcohol consumption and abstinence from smoking, is associated with a major decrease in the incidence of chronic diseases and mortality. Primary health-care (PHC) services therefore attempt, with rather limited success, to promote such lifestyles in their patients. The objective of the present study is to ascertain the perceptions of clinicians and researchers within the Basque Health System of the factors that hinder or facilitate the integration of healthy lifestyle promotion in routine PHC setting.

Methods

Formative research based on five consensus meetings held by an expert panel of 12 PHC professionals with clinical and research experience in health promotion, supplied with selected bibliographic material. These meetings were recorded, summarized and the provisional findings were returned to participants in order to improve their validity.

Results

The Health Belief Model, the Theory of Planned Action, the Social Learning Theory, "stages of change" models and integrative models were considered the most useful by the expert panel. Effective intervention strategies, such as the "5 A's" strategy (assess, advise, agree, assist and arrange) are also available. However, none of these can be directly implemented or continuously maintained under current PHC conditions. These strategies should therefore be redesigned by adjusting the intervention objectives and contents to the operation of primary care centres and, in turn, altering the organisation of the centres where they are to be implemented.

Conclusion

It is recommended to address optimisation of health promotion in PHC from a research perspective in which PHC professionals, researchers and managers of these services cooperate in designing and evaluating innovative programs. Future strategies should adopt a socio-ecological approach in which the health system plays an essential role but which nevertheless complements other individual, cultural and social factors that condition health. These initiatives require an adequate theoretical and methodological framework for designing and evaluating complex interventions.
Literature
1.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL: Actual causes of death in the United States, 2000. JAMA. 2004, 291: 1238-1245. 10.1001/jama.291.10.1238.CrossRefPubMed
2.
Goldstein MG, Whitlock EP, DePue J: Multiple behavioral risk factor interventions in primary care: summary of research evidence. Am J Prev Med. 2004, 27 (suppl 1): 61-79. 10.1016/j.amepre.2004.04.023.CrossRefPubMed
3.
Galan I, Rodriguez-Artalejo F, Díez-Gañán L, Tobías A, Zorrilla B, Gandarillas A: Clustering of behavioural risk factors and compliance with clinical preventive recommendations in Spain. Prev Med. 2006, 42: 343-347. 10.1016/j.ypmed.2006.01.018.CrossRefPubMed
4.
WHO: The World Health Report. Reducing risks, promoting healthy life. 2002, Geneva: WHO
5.
Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N: Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008, 8,5: e12-10.1371/journal.pmed.0050012. Erratum in: PLoS Med 2008, 18,5:e70CrossRef
6.
Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, van Staveren WA: Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004, 292: 1433-1439. 10.1001/jama.292.12.1433.CrossRefPubMed
7.
8.
Royal College of General Practitioners: Reports from general practice 18–21. 1984, London: Royal College of General Practitioners
9.
PAPPS: Program of Preventive Activities and Health Promotion from the Spanish Society of Family and Community Medicine. [Accessed February 25, 2006], [http://​www.​papps.​org]
10.
Whitlock EP, Orleans CT, Pender N, Allan J: Evaluating primary care behavioural counselling interventions: an evidence-based approach. Am J Prev Med. 2002, 22: 267-284. 10.1016/S0749-3797(02)00415-4.CrossRefPubMed
11.
Grandes G, Cortada J, Arrazola A: An evidence-based program for smoking cessation: effectiveness in routine general practice. Br J Gen Pract. 2000, 50: 803-807.PubMedPubMedCentral
12.
Orleans CT: Addressing multiple behavioral health risks in primary care. Broadening the focus of health behavior change research and practice. Am J Prev Med. 2004, 27 (2 Suppl): 1-3. 10.1016/j.amepre.2004.05.001.CrossRefPubMed
13.
Lopez-de-Munain J, Torcal J, Lopez V, Garay J: Prevention in Routine General Practice: Activity Patterns and Potential Promoting Factors. Prev Med. 2001, 32: 13-22. 10.1006/pmed.2000.0777.CrossRefPubMed
14.
Hulscher ME, Wensing M, Grol RP, Weijden van der T, van Weel C: Interventions to improve the delivery of preventive services in primary care. Am J Public Health. 1999, 89: 737-746.CrossRefPubMedPubMedCentral
15.
Hulscher M, Wensing M, Weijen van der T, Grol R: Interventions to implement prevention in primary care. Cochrane Database of Systematic Reviews. 2006, 4.
16.
WHO: Alma Ata Declaration. 1978, Geneva: WHO
17.
WHO: Ottawa Charter for Health Promotion. 1986, Geneva: WHO
18.
Grandes G, Sanchez A, Cortada J, Calderon C, Balague L, Millan E, Arrazola A, Benavides R, Goiria B, Mujika J, Torcal J, Vergara I: Useful strategies for the promotion of healthy lifestyles in Primary Health Care. [Document in Spanish] Investigación Comisionada. Vitoria-Gasteiz. Departamento de Sanidad, Gobierno Vasco. 2008, . Informe n° Osteba D-08-07
19.
20.
Elder JP, Ayala GX, Harris S: Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med. 1999, 17: 275-84. 10.1016/S0749-3797(99)00094-X.CrossRefPubMed
21.
Hochbaum GM: Public participation in medical screening programs: a sociopsychological study. PHS publication no. 752. 1958, Washington, DC: Government Printing Office
22.
Rosentock IM: Historical origins of the Health Belief Model. Health Education Monographs. 1974, 2: 328-335.CrossRef
23.
Fishbein M: Readings in attitude theory and measurement. 1967, New York: Wiley
24.
Fishbein M, Ajzen I: Belief, attitude, intention, and behavior. 1975, Reading, MA: Addison-Wesley
25.
Ajzen I: Attitude, personality and actions: Dispositional prediction in behavior. 1988, Chicago: Dorsey Press
26.
Lewis MA, DeVellis BM, Sleath B: Social influence and interpersonal communication in health behaviour. Health behavior and health education: Theory, research, and practice. Edited by: Glanz K, Rimer BK, Lewis FM. 2002, San Francisco, CA: Jossey Bass, 240-264. 3
27.
Prochaska JO, Diclemente CC: Stages and procesess of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983, 51: 390-395. 10.1037/0022-006X.51.3.390.CrossRefPubMed
28.
Weinstein ND: The Precaution Adoption Process. Health Psychol. 1988, 7: 355-386. 10.1037/0278-6133.7.4.355.CrossRefPubMed
29.
Weinstein ND, Sandman PM: A model of the Precaution Adoption Process: Evidence from home random testing. Health Psychol. 1992, 11: 170-180. 10.1037/0278-6133.11.3.170.CrossRefPubMed
30.
Skinner BF: Science and Human Behavior. 1953, New York: Macmillan
31.
Bandura A: Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977, 84: 191-215. 10.1037/0033-295X.84.2.191.CrossRefPubMed
32.
Bandura A: Social Foundation of Thought and Action. 1986, Englewood Cliffs, NJ: Prentice Hall
33.
Kanfer FH: Self-management methods. Helping People Change. Edited by: Kanfer FH, Goldstein MG. 1975, New York: Pergamon, 309-316.
34.
Heaney CA, Israel BA: Social networks and social support. Health behavior and health education: Theory, research, and practice. Edited by: Glanz K, Rimer BK, Lewis FM. 2002, San Francisco, CA: Jossey Bass, 185-209. 3
35.
Minkler M, Wallerstein NB: Improving health through community organization and community building. Health behavior and health education: Theory, research, and practice. Edited by: Glanz K, Rimer BK, Lewis FM. 2002, San Francisco, CA: Jossey Bass, 279-311. 3
36.
Oldenburg B, Parcel GS: Diffusion of innovations. Health behavior and health education: Theory, research, and practice. Edited by: Glanz K, Rimer BK, Lewis FM. 2002, San Francisco, CA: Jossey Bass, 312-334. 3
37.
Fishbein M: The role of theory in HIV prevention. AIDS Care. 2000, 12: 273-278. 10.1080/09540120050042918.CrossRefPubMed
38.
Glanz K, Rimer BK, Lewis FM: Health Behavior and Health Education. Theory, Research and Practice. 2002, San Fransisco: Wiley & Sons
39.
40.
Van Sluijs EM, Van Poppel MN, Twisk JW, Brug J, Van Mechelen W: The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention. Health Educ Res. 2005, 20: 345-356. 10.1093/her/cyg129.CrossRefPubMed
41.
Petrella RJ, Koval JJ, Cunningham DA, Paterson DH: Can primary care doctors prescribe exercise to improve fitness? The Step Test Exercise Prescription (STEP) project. Am J Prev Med. 2003, 24: 316-322. 10.1016/S0749-3797(03)00022-9.CrossRefPubMed
42.
Pinto BM, Lynn H, Marcus BH, DePue J, Goldstein MG: Physician-based activity counseling: intervention effects on mediators of motivational readiness for physical activity. Ann Behav Med. 2001, 23: 2-10. 10.1207/S15324796ABM2301_2.CrossRefPubMed
43.
Norris SL, Grothaus LC, Buchner DM, Pratt M: Effectiveness of physician-based assessment and counseling for exercise in a staff model HMO. Prev Med. 2000, 30: 513-523. 10.1006/pmed.2000.0673.CrossRefPubMed
44.
Steptoe A, Rink E, Kerry S: Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care. Prev Med. 2000, 31: 183-194. 10.1006/pmed.2000.0688.CrossRefPubMed
45.
Naylor PJ, Simmonds G, Riddoch C, Velleman G, Turton P: Comparison of stage-matched and unmatched interventions to promote exercise behaviour in the primary care setting. Health Educ Res. 1999, 14: 653-666. 10.1093/her/14.5.653.CrossRefPubMed
46.
Perkins-Porras L, Cappuccio FP, Rink E, Hilton S, McKay C, Steptoe A: Does the effect of behavioral counseling on fruit and vegetable intake vary with stage of readiness to change?. Prev Med. 2005, 40: 314-320. 10.1016/j.ypmed.2004.06.002.CrossRefPubMed
47.
Steptoe A, Perkins-Porras L, Rink E, Hilton S, Cappuccio FP: Psychological and social predictors of changes in fruit and vegetable consumption over 12 months following behavioral and nutrition education counseling. Health Psychol. 2004, 23: 574-581. 10.1037/0278-6133.23.6.574.CrossRefPubMed
48.
John JH, Yudkin PL, Neil HA, Ziebland S: Does stage of change predict outcome in a primary-care intervention to encourage an increase in fruit and vegetable consumption?. Health Educ Res. 2003, 18: 429-438. 10.1093/her/cyf035.CrossRefPubMed
49.
Kristal AR, Hedderson MM, Patterson RE, Neuhouser M: Predictors of self-initiated, healthful dietary change. J Am Diet Assoc. 2001, 101: 762-766. 10.1016/S0002-8223(01)00191-2. Erratum in: J Am Diet Assoc 2001, 101:997CrossRefPubMed
50.
Steptoe A, Doherty S, Kerry S, Rink E, Hilton S: Sociodemographic and psychological predictors of changes in dietary fat consumption in adults with high blood cholesterol following counseling in primary care. Health Psychol. 2000, 19: 411-419. 10.1037/0278-6133.19.5.411.CrossRefPubMed
51.
Beresford SA, Curry SJ, Kristal AR, Lazovich D, Feng Z, Wagner EH: A dietary intervention in primary care practice: the Eating Patterns Study. Am J Public Health. 1997, 87: 610-616.CrossRefPubMedPubMedCentral
52.
Grandes G, Cortada JM, Arrazola A, Laka JP: Predictors of long-term outcome of a smoking cessation program in primary care. Br J Gen Pract. 2003, 53: 101-107.PubMedPubMedCentral
53.
Pieterse ME, Seydel ER, DeVries H, Mudde AN, Kok GJ: Effectiveness of a minimal contact smoking cessation program for Dutch general practitioners: a randomized controlled trial. Prev Med. 2001, 32: 182-190. 10.1006/pmed.2000.0791.CrossRefPubMed
54.
Senore C, Battista RN, Shapiro SH, Segnan N, Ponti A, Rosso S, Aimar D: Predictors of smoking cessation following physicians' counseling. Prev Med. 1998, 27: 412-421. 10.1006/pmed.1998.0286.CrossRefPubMed
55.
Kaner EFS, Dickinson HO, Beyer F, Pienaar E, Campbell F, Schlesinger C, Heather N, Saunders J, Burnand B: Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews. 2007, Art No.: CD004148, 2CrossRef
56.
Whitlock EP, Polen MR, Green CA, Orleans T, Klein J, U.S. Preventive Services Task Force: Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2004, 140: 557-568.CrossRefPubMed
57.
Bertholet N, Daeppen JB, Wietlisbach V, Fleming M, Burnand B: Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005, 165: 986-995. 10.1001/archinte.165.9.986.CrossRefPubMed
58.
Poikolainen K: Effectiveness of brief interventions to reduce alcohol intake in primary health care populations: a meta-analysis. Prev Med. 1999, 28: 503-509. 10.1006/pmed.1999.0467.CrossRefPubMed
59.
Ballesteros J, Ariño J, González-Pinto A, Querejeta I: Effectiveness of medical advice for reducing excessive alcohol consumption. Meta-analysis of Spanish studies in primary care [Article in Spanish]. Gac Sanit. 2003, 17: 116-122. 10.1157/13046568.CrossRefPubMed
60.
Fiore MC, Bailey WC, Cohen SJ, Dorfman SF, Goldstein MG, Gritz ER, Heyman RB, Jaén CR, Kottke TE, Lando HA, Mecklenburg RE, Mullen PD, Nett LM, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME: Treating tobacco use and dependence, clinical practice guideline. 2000, Rockville MD: U.S. Department of Health and Human Services, Public Health Services
61.
Lancaster T, Stead LF: Physician advice for smoking cessation. The Cochrane Database of Systematic Reviews. 2004, Art No.:CD000165, 4CrossRef
62.
Rice VH, Stead LF: Issue 1. Nursing interventions for smoking cessation. The Cochrane Database of Systematic Reviews. 2004
63.
Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM: Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002, 137: 208-215.CrossRefPubMed
64.
65.
Simons-Morton DG, Calfas KJ, Oldenburg B, Burton NW: Effects of interventions in health care settings on physical activity or cardiorespiratory fitness. Am J Prev Med. 1998, 15: 413-430. 10.1016/S0749-3797(98)00078-6.CrossRefPubMed
66.
Lawlor DA, Hanratty B: The effect of physical activity advice given in routine primary care consultations: a systematic review. Public Health Med. 2001, 23: 219-226. 10.1093/pubmed/23.3.219.CrossRef
67.
Smith BJ: Promotion of physical activity in primary health care: update of the evidence on interventions. J Sci Med Sport. 2004, 7 (Suppl 1): 67-73. 10.1016/S1440-2440(04)80280-9.CrossRefPubMed
68.
Hillsdon M, Foster C, Thorogood M: Interventions for promoting physical activity. Cochrane Database Syst Rev. 2005, Art No:CD003180, 2
69.
Tulloch H, Fortier M, Hogg W: Physical activity counseling in primary care: Who has and who should be counseling?. Patient Educ Couns. 2006, 64: 6-20. 10.1016/j.pec.2005.10.010.CrossRefPubMed
70.
Pignone MP, Ammerman A, Fernandez L, Orleans CT, Pender N, Woolf S, Lohr KN, Sutton S: Counseling to promote a healthy diet in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med. 2003, 24: 75-92. 10.1016/S0749-3797(02)00580-9.CrossRefPubMed
71.
U.S. Preventive Services Task Force: Behavioral counseling in primary care to promote a healthy diet: recommendations and rationale. Am J Prev Med. 2003, 24: 93-100. 10.1016/S0749-3797(02)00581-0.CrossRef
72.
73.
Brunner EJ, Thorogood M, Rees K, Hewitt G: Issue 4. Dietary advice for reducing cardiovascular risk. The Cochrane Database of Systematic Reviews. 2005, Art No:CD002128.
74.
Priozzo S, Summerbell C, Cameron C, Glasziou P: Issue 2. Advice on low-fat diets for obesity. The Cochrane Database of Systematic Reviews. 2002, Art No:CD003640.
75.
Goldstein MG, DePue J, Kazuira A: Models for provider-patient interaction: applications to health behavior change. The handbook of health behavior change. Edited by: Shumaker SA, Schon EB, Ockene JK, McBeem WL. 1998, Springer, New York, 85-113. 2
76.
Burke BL, Arkowitz H, Menchola M: The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003, 71: 843-861. 10.1037/0022-006X.71.5.843.CrossRefPubMed
77.
Dunn C, Deroo L, Rivara FP: The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction. 2001, 96: 1725-1742. 10.1046/j.1360-0443.2001.961217253.x.CrossRefPubMed
78.
Rubak S, Sandbaek A, Lauritzen T, Christensen B: Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005, 55: 305-312.PubMedPubMedCentral
79.
Hoffmeister H, Mensink GBM: Community-based intervention trials in developed countries: Oxford textbook of public health. 2004, Oxford University Press, 4
80.
81.
Ebrahim S, Beswick A, Burke M, Davey Smith G: Multiple risk factor interventions for primary prevention of coronary heart disease. The Cochrane Database of Systematic Reviews. 2006, Art No.:CD001561, 4
82.
van Bokhoven MA, Kok G, Weijden van der T: Designing a quality improvement intervention: a systematic approach. Qual Saf Health Care. 2003, 12: 215-220. 10.1136/qhc.12.3.215.CrossRefPubMedPubMedCentral
83.
Medical Research Council: A framework for development and evaluation of complex interventions to improve health. 2000, London: Medical Research Council
84.
Campbell NC, Murray E, Darbyshire J, Emery J, Farmer A, Griffiths F, Guthrie B, Lester H, Wilson P, Kinmonth AL: Designing and evaluating complex interventions to improve health care. BMJ. 2007, 334: 455-459. 10.1136/bmj.39108.379965.BE.CrossRefPubMedPubMedCentral
85.
Kottke TE, Solberg LI: Beyond efficacy testing redux. Am J Prev Med. 2004, 27 (2 Suppl): 104-105. 10.1016/j.amepre.2004.04.027.CrossRefPubMed
86.
Kottke TE, Solberg LI: Optimizing practice through research: a preventive services case study. Am J Prev Med. 2007, 33: 505-506. 10.1016/j.amepre.2007.08.003.CrossRefPubMed
87.
Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003, 362: 1225-1230. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed
88.
Grol R, Wensing M: What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004, 180 (6 Suppl): S57-60.PubMed
89.
Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA: Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ. 1998, 317: 465-468.CrossRefPubMedPubMedCentral
90.
Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O'Brien MA: Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001, 39 (8 Suppl 2): II2-45.PubMed
91.
Shaw B, Cheater F, Baker R, Gillies C, Hearnshaw H, Flottorp S, Robertson N: Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews. 2005, CD005470-3
92.
Wensing M, Wollersheim H, Grol R: Organizational interventions to implement improvements in patient care: a structured review of reviews. Implement Sci. 2006, 22 (1): 2-10.1186/1748-5908-1-2.CrossRef
93.
Wagner EH, Austin BT, Von Korff M: Organizing Care for Patients with Chronic Illness. Milbank Q. 1996, 74: 511-544. 10.2307/3350391.CrossRefPubMed
94.
Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, Salivaras S: The expanded chronic care model: an integration of concepts and strategies from population health promotion and the chronic care model. Hosp Q. 2003, 7: 73-82.PubMed
95.
Glasgow RE, Orleans CT, Wagner EH: Does the chronic care model serve also as a template for improving prevention?. Milbank Q. 2001, 79: 579-612. 10.1111/1468-0009.00222.CrossRefPubMedPubMedCentral
96.
Hung DY: Improving the delivery of preventive care services. Manag Care Interface. 2007, 20: 38-44.PubMed
97.
Hung DY, Rundall TG, Tallia AF, Cohen DJ, Halpin HA, Crabtree BF: Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors. Milbank Q. 2007, 85: 69-91. 10.1111/j.1468-0009.2007.00477.x.CrossRefPubMedPubMedCentral
98.
Cifuentes M, Fernald DH, Green LA, Niebauer LJ, Crabtree BF, Stange KC, Hassmiller SB: Prescription for health: changing primary care practice to foster healthy behaviors. Ann Fam Med. 2005, 3 (Suppl 2): S4-11. 10.1370/afm.378.CrossRefPubMedPubMedCentral
99.
WHO: Global Strategy on Diet, Physical Activity and Health. 2004, Geneva: WHO
100.
Bradley F, Wiles R, Kinmonth A-L, Mant D, Gantley M: Development and evaluation of complex interventions in health services research: case study of the Southampton heart integrated care project (SHIP). BMJ. 1999, 318: 711-715.CrossRefPubMedPubMedCentral
101.
Byrne M, Cupples M, Smith SM, Leatham C, Corrigan M, Byrne MC, Murphy AW: Development of a Complex Intervention Secondary Prevention of Coronary Heart Disease in Primary Care Using the UK Medical Research Council Framework. Am J Manag Care. 2006, 12: 261-266.PubMed
102.
Murchie P, Hannaford PC, Wyke S, Nicolson MC, Campbell NC: Designing an integrated follow-up program for people treated for cutaneous malignant melanoma: a practical application of the MRC framework for the design and evaluation of complex interventions to improve health. Fam Pract. 2007, 24: 283-292. 10.1093/fampra/cmm006.CrossRefPubMed
103.
Pronk NP, Peek CJ, Goldstein MG: Addressing multiple behavioral risk factors in primary care. A synthesis of current knowledge and stakeholder dialogue sessions. Am J Prev Med. 2004, 27 (2 Suppl): 4-17. 10.1016/j.amepre.2004.04.024.CrossRefPubMed
104.
Woolf SH, Glasgow RE, Krist A, Bartz C, Flocke SA, Holtrop JS, Rothemich SF, Wald ER: Putting it together: finding success in behavior change through integration of services. Ann Fam Med. 2005, 3 (Suppl 2): S20-27. 10.1370/afm.367.CrossRefPubMedPubMedCentral
105.
Mold JW, Peterson KA: Primary care practice-based research networks: working at the interface between research and quality improvement. Ann Fam Med. 2005, 3 (Suppl 1): S12-20. 10.1370/afm.303.CrossRefPubMedPubMedCentral
Metadata
Title
Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers
Authors
Gonzalo Grandes
Alvaro Sanchez
Josep M Cortada
Laura Balague
Carlos Calderon
Arantza Arrazola
Itziar Vergara
Eduardo Millan
the "Prescribe Vida Saludable" group
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2008
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-8-213

Other articles of this Issue 1/2008

BMC Health Services Research 1/2008 Go to the issue

Research article

Adolescents perception of reproductive health care services in Sri Lanka

Research article

From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

Research article

Intra-articular hyaluronic acid for treatment of osteoarthritis: a nationwide study among the older population of Taiwan

Study protocol

Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857)

Research article

Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study): A study of protocols in Greater London

Research article

Socioeconomic patterns in the use of public and private health services and equity in health care