Article Text
Abstract
Objective To evaluate the implementation and development of a complex intervention on health promotion and changes in health-promoting behaviours in primary healthcare according to healthcare attendees and health professionals.
Design Descriptive qualitative evaluation research conducted with 94 informants. Data collection techniques consisted of 14 semistructured individual interviews, 9 discussion groups, 1 triangular group and 6 documents. Three analysts carried out a thematic content analysis with the support of Atlas.ti software. This evaluation was modelled on Proctor and colleagues’ concept of outcomes for implementation research.
Setting 7 primary care centres from seven Spanish regions: Andalusia, Aragon, Balearic Islands, Basque Country, Castilla-La Mancha, Castilla-Leon and Catalonia.
Participants The study population were healthcare attendees (theoretical sampling) and health professionals (opportunistic sampling) who had participated in the exploratory trial of the EIRA intervention (2015).
Results Healthcare attendees and professionals had a positive perception of the study. Healthcare attendees even reported that they would recommend participation to family and friends. Health professionals became aware of the significance of the motivational interview, especially for health promotion, and emphasised social prescribing of physical activity. They also put forward recommendations to improve recruitment, screening and retention of participants. Healthcare attendees modified behaviours and health professionals modified working practices. To achieve sustainability, health professionals believe that it is crucial to adapt agendas and involve all the staff.
Conclusions The discourses of all stakeholders on the intervention must be taken into consideration for the successful, setting-specific implementation of adequate, acceptable, equitable and sustainable strategies aimed at health promotion and well-being.
- complex interventions
- implementation research
- evaluation
- health promotion
- primary health care
- qualitative research
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Footnotes
Contributors MP-V, AB and EP-R designed the study and wrote the protocol. EP-R, MP-V, AB, BM, MP-F, SM, HP, CR and JAB participated in data collection and generation techniques. MP-V, NC-A and EP-R conducted the analysis. All authors contributed to the interpretation of results. MP-V, AB and EP-R wrote the first draft of the manuscript. All authors read, contributed and approved the final version of the manuscript.
Funding This project has been funded by the Carlos III Health Institute (Ministry of Economy and Competitiveness, Spain) with a grant for Research Projects on Health (PI12/01914; PI12/001616; PI12/02608; PI12/01974; PI12/02774; PI12/02635; PI12/02379; and P15/00114) through the Network for Prevention and Health Promotion in Primary Care (redIAPP, RD12/0005/0001; RD16/0007/0001) and by European Union European Regional Development Fund (ERDF) funds (European Regional Development Fund).
Competing interests None declared.
Ethics approval The study was approved by the Research Ethics Committee of the IDIAP Jordi Gol (2013; P12/073). The authors guarantee the accuracy, transparency and honesty of the data and information contained in the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Patient consent for publication Obtained.