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

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2009

Open Access 01-12-2009 | Study protocol

Modelling innovative interventions for optimising healthy lifestyle promotion in primary health care: "Prescribe Vida Saludable" phase I research protocol

Authors: Alvaro Sanchez, Gonzalo Grandes, Josep M Cortada, Haizea Pombo, Laura Balague, Carlos Calderon

Published in: BMC Health Services Research | Issue 1/2009

Login to get access

Abstract

Background

The adoption of a healthy lifestyle, including physical activity, a balanced diet, a moderate alcohol consumption and abstinence from smoking, are associated with large decreases in the incidence and mortality rates for the most common chronic diseases. That is why primary health care (PHC) services are trying, so far with less success than desirable, to promote healthy lifestyles among patients. The objective of this study is to design and model, under a participative collaboration framework between clinicians and researchers, interventions that are feasible and sustainable for the promotion of healthy lifestyles in PHC.

Methods and design

Phase I formative research and a quasi-experimental evaluation of the modelling and planning process will be undertaken in eight primary care centres (PCCs) of the Basque Health Service – OSAKIDETZA, of which four centres will be assigned for convenience to the Intervention Group (the others being Controls). Twelve structured study, discussion and consensus sessions supported by reviews of the literature and relevant documents, will be undertaken throughout 12 months. The first four sessions, including a descriptive strategic needs assessment, will lead to the prioritisation of a health promotion aim in each centre. In the remaining eight sessions, collaborative design of intervention strategies, on the basis of a planning process and pilot trials, will be carried out. The impact of the formative process on the practice of healthy lifestyle promotion, attitude towards health promotion and other factors associated with the optimisation of preventive clinical practice will be assessed, through pre- and post-programme evaluations and comparisons of the indicators measured in professionals from the centres assigned to the Intervention or Control Groups.

Discussion

There are four necessary factors for the outcome to be successful and result in important changes: (1) the commitment of professional and community partners who are involved; (2) their competence for change; (3) the active cooperation and participation of the interdisciplinary partners involved throughout the process of change; and (4) the availability of resources necessary to facilitate the change.
Appendix
Available only for authorised users
Literature
1.
Grandes G, Sánchez A, Cortada JM, Balague L, Calderon C, Arrazola A, Vergara I, Millan E, for the "Prescribe Vida Saludable" group: Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers. BMC Health Services Research. 2008, 8: 213.CrossRefPubMedPubMedCentral
2.
Michie S: Designing and implementing behaviour change interventions to improve population health. J Health Serv Res Policy. 2008, 13 (Suppl 3): 64-9. 10.1258/jhsrp.2008.008014.CrossRefPubMed
3.
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
4.
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
5.
Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. Journal of Clinical Epidemiology. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed
6.
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, CD004148-2
7.
Lancaster T, Stead LF: Physician advice for smoking cessation. The Cochrane Database of Systematic Reviews. 2004, CD000165-4
8.
Rice VH, Stead LF: Nursing interventions for smoking cessation. The Cochrane Database of Systematic Reviews. 2004, CD001188-1
9.
Hillsdon M, Foster C, Thorogood M: Interventions for promoting physical activity. Cochrane Database Syst Rev. 2005, CD003180-2
10.
Grandes G, Sánchez A, Ortega R, Torcal J, Montoya I, Lizarraga K, Serra J, PEPAF Group: Effectiveness of physical activity advice and prescription by physicians in routine primary care: a cluster randomised trial. Arch Intern Med. 2009, 169 (7): 694-701. 10.1001/archinternmed.2009.23.CrossRefPubMed
11.
12.
Brunner EJ, Thorogood M, Rees K, Hewitt G: Dietary advice for reducing cardiovascular risk. The Cochrane Database of Systematic Reviews. 2005, CD002128-4
13.
Priozzo S, Summerbell C, Cameron C, Glasziou P: Advice on low-fat diets for obesity. The Cochrane Database of Systematic Reviews. 2002, CD003640-2
14.
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
15.
Michie S, Abraham C: Interventions to change health behaviours: evidence-based or evidence-inspired?. Psychology & Health. 2004, 19: 29-49. 10.1080/0887044031000141199.CrossRef
16.
Green LW, Kreuter MW: Health Program Planning: An Educational and Ecological Approach. 2005, NY: McGraw-Hill Higher Education, 4
17.
Bartholomew LK: Intervention Mapping: A process for developing theory and evidence-based health education programs. Health Education & Behavior. 1998, 25: 545-563. 10.1177/109019819802500502.CrossRef
18.
Hardeman W, Sutton S, Griffin S, Johnston M, White A, Wareham NJ, Kinmonth AL: A causal modelling approach to the development of theory-based behaviour change programmes for trial evaluation. Health Educ Res. 2005, 20: 676-87. 10.1093/her/cyh022.CrossRefPubMed
19.
Abraham C, Michie S: A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008, 27: 379-87. 10.1037/0278-6133.27.3.379.CrossRefPubMed
20.
National Institute for Health and Clinical Excellence: Behaviour change at population, community and individual levels. NICE Public Health Guidance. 2007, London: NICE
21.
Ockene JK, Edgerton EA, Teutsch SM, Marion LN, Miller T, Genevro JL, Loveland-Cherry CJ, Fielding JE, Briss PA: Integrating evidence-based clinical and community strategies to improve health. Am J Prev Med. 2007, 32: 244-52. 10.1016/j.amepre.2006.11.007.CrossRefPubMed
22.
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
23.
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
24.
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004, 8 (6): 1-72.CrossRef
25.
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
26.
Freemantle N, Harvey EL, Wolf F, Grimshaw JM, Grilli R, Bero LA: Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2000, CD000172-2
27.
Jamtvedt G, Young JM, Kristoffersen DT, O'Brien MA, Oxman AD: Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006, 19 (2): CD000259.
28.
Zwarenstein M, Bryant W: Interventions to promote collaboration between nurses and doctors. Cochrane Database Syst Rev. 2000, CD000072-2
29.
Reeves S, Zwarenstein M, Goldman J, Barr H, Freeth D, Hammick M, Koppel I: Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2008, 23 (1): CD002213.
30.
Schouten LM, Hulscher ME, van Everdingen JJ, Huijsman R, Grol RP: Evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008, 336: 1491-4. 10.1136/bmj.39570.749884.BE.CrossRefPubMedPubMedCentral
31.
Smith SM, Allwright S, O'Dowd T: Effectiveness of shared care across the interface between primary and specialty care in chronic disease management. Cochrane Database Syst Rev. 2007, 18 (3): CD004910.
32.
O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis DA, Haynes RB, Harvey EL: Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2007, 17 (4): CD000409.
33.
Jacobson VJ, Szilagyi P: Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev. 2005, 20 (3): CD003941.
34.
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. 10.2105/AJPH.89.5.737.CrossRefPubMedPubMedCentral
35.
Hulscher M, Wensing M, Weijen van der T, Grol R: Interventions to implement prevention in primary care. Cochrane Database of Systematic Reviews. 2006, CD000362-1
36.
37.
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
38.
39.
Green LA, Cifuentes M, Glasgow RE, Stange KC: Redesigning primary care practice to incorporate health behavior change: prescription for health round-2 results. Am J Prev Med. 2008, 35 (5 Suppl): 347-9. 10.1016/j.amepre.2008.08.013.CrossRef
40.
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
41.
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
42.
Scott I: The evolving science of translating research evidence into clinical practice. Evidence-Based Medicine. 2007, 12: 4-7. 10.1136/ebm.12.1.4.CrossRefPubMed
43.
Medical Research Council: A framework for development and evaluation of complex interventions to improve health. 2000, London: Medical Research Council
44.
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
45.
46.
Mercer SL, DeVinney BJ, Fine LJ, Green LW, Dougherty D: Study designs for effectiveness and translation research: identifying trade-offs. Am J Prev Med. 2007, 33: 139-154. 10.1016/j.amepre.2007.04.005.CrossRefPubMed
47.
Basque Government Health Department: Encuesta de salud de la C. A. del País Vasco 2002. 2004, Vitoria-Gasteiz: Servicio Central de Publicaciones del Gobierno Vasco
48.
Basque Government Health Department: Encuesta de salud de la C. A. del País Vasco 2007. 2004, Vitoria-Gasteiz: Servicio Central de Publicaciones del Gobierno Vasco
49.
50.
Hanlon JJ, Pickett GE: Public Health Administration and Practice. 1984, Times Mirror/Mosby, St-Louis, 8
51.
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. Informe Osteba, Departamento de Sanidad, Gobierno Vasco. 2008
52.
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
53.
Ohman-Strickland PA, John Orzano A, Nutting PA, Perry Dickinson W, Scott-Cawiezell J, Hahn K, Gibel M, Crabtree BF: Measuring organizational attributes of primary care practices: development of a new instrument. Health Serv Res. 2007, 42: 1257-73. 10.1111/j.1475-6773.2006.00644.x.CrossRefPubMedPubMedCentral
54.
Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM: Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. Health Educ Res. 2006, 21: 688-694. 10.1093/her/cyl081.CrossRefPubMed
55.
Beer M, Eisenstat RA, Spector B: Why change programs don't produce change. Harvard Business Review. 1990, 68: 158-66.PubMed
56.
57.
Ruhe MC, Weyer SM, Zronek S, Wilkinson A, Wilkinson PS, Stange KC: Facilitating practice change: lessons from the STEP-UP clinical trial. Prev Med. 2005, 40: 729-734. 10.1016/j.ypmed.2004.09.015.CrossRefPubMed
58.
Cohen D, McDaniel RR, Crabtree BF, Ruhe MC, Weyer SM, Tallia A, Miller WL, Goodwin MA, Nutting P, Solberg LI, Zyzanski SJ, Jaén CR, Gilchrist V, Stange KC: A practice change model for quality improvement in primary care practice. J Healthc Manag. 2004, 49: 155-168.PubMed
Metadata
Title
Modelling innovative interventions for optimising healthy lifestyle promotion in primary health care: "Prescribe Vida Saludable" phase I research protocol
Authors
Alvaro Sanchez
Gonzalo Grandes
Josep M Cortada
Haizea Pombo
Laura Balague
Carlos Calderon
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2009
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-9-103

Other articles of this Issue 1/2009

BMC Health Services Research 1/2009 Go to the issue

Research article

Service network analysis for agricultural mental health

Research article

Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links

Research article

A pharmaco-economic analysis of patients with schizophrenia switching to generic risperidone involving a possible compliance loss

Research article

Identifying research priorities for health care priority setting: a collaborative effort between managers and researchers

Research article

Re-organisation of oesophago-gastric cancer care in England: progress and remaining challenges

Research article

The index of rural access: an innovative integrated approach for measuring primary care access