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BMC Primary Care

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Open Access 01-12-2021 | Care | Research

What is a prevention visit? A qualitative study of a structured approach to prevention and screening – the BETTER WISE project

Authors: N. Sopcak, C. Fernandes, M. A. O’Brien, D. Ofosu, M. Wong, T. Wong, M. Kebbe, D. Manca

Published in: BMC Primary Care | Issue 1/2021

Abstract

Background

This qualitative study is a sub-component of BETTER WISE, a comprehensive and structured approach that proactively addresses chronic disease prevention, screening, and cancer survivorship, including screening for poverty and addressing lifestyle risks for patients aged 40 to 65. Patients (n = 527) from 13 primary care clinics (urban, rural, and remote) in Alberta, Ontario, and Newfoundland & Labrador, Canada agreed to participate in the study and were invited to a one-hour prevention visit delivered by a Prevention Practitioner (PP) as part of BETTER WISE. We identified the key components of a BETTER WISE prevention visit based on patients’ and primary care providers’ perspectives.

Methods

Primary care providers (PPs, physicians and their staff) participated in 14 focus groups and 19 key informant interviews to share their perspectives on the BETTER WISE project. Of 527 patients who agreed to participate in the study and were invited for a BETTER WISE prevention visit with a PP, we received 356 patient feedback forms. We also collected field notes and memos and employed thematic analysis using a constant comparative method focusing on the BETTER WISE prevention visit.

Results

We identified four key themes related to a BETTER WISE prevention visit: 1) Creating a safe environment and building trust with patients: PPs provided sufficient time and a safe space for patients to share what was important to them, including their concerns related to poverty, alcohol consumption, and mental health, topics that were often not shared with physicians; 2) Providing personalized health education: PPs used the BETTER WISE tools to provide patients with a personalized overview of their health status and eligible screening; 3) Non-judgmental empowering of patients: Instead of directing patients on what to do, PPs evoked patients’ preferences and helped them to set goals (if desired); and 4) Integrating care for patients: PPs clarified information from patients’ charts and surveys with physicians and helped patients to navigate resources within and outside of the primary care team.

Conclusions

The results of this study underscore the importance of personalized, trusting, non-judgmental, and integrated relationships between primary care providers and patients to effectively address chronic disease prevention, screening, and cancer survivorship as demonstrated by the BETTER WISE prevention visits.

Trial registration

This qualitative study is a sub-component of the BETTER WISE pragmatic, cRCT, trial registration ISRCTN21333761 (date of registration 19/12/2016)

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Title: What is a prevention visit? A qualitative study of a structured approach to prevention and screening – the BETTER WISE project
Authors: N. Sopcak
C. Fernandes
M. A. O’Brien
D. Ofosu
M. Wong
T. Wong
M. Kebbe
D. Manca
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/s12875-021-01503-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

What is a prevention visit? A qualitative study of a structured approach to prevention and screening – the BETTER WISE project

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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