Abstract
BackgroundPrimary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities.ObjectiveTo identify proposals to approach HP in the context of primary care according to health‐care users aged 45‐75 years, key community informants and primary care centre (PCC) workers.MethodsDescriptive‐interpretive qualitative research with 276 participants from 14 PCC of seven Spanish regions. A theoretical sampling was used for selection. A total of 25 discussion groups, two triangular groups and 30 semi‐structured interviews were carried out. A thematic interpretive contents analysis was carried out.ResultsParticipants consider that HP is not solely a matter for the health sector and they emphasize intersectoral collaboration. They believe that it is important to strengthen community initiatives and to create a healthy social environment that encourages greater responsibility and participation of health‐care users in decisions regarding their own health and better management of public services and resources. HP, care in the community and demedicalization should be priorities for PHC. Participants propose organizational changes in the PCC to improve HP. PCC workers are aware that HP falls within the scope of their responsibilities and propose to increase their training, motivation, competences and knowledge of the social environment. Informants emphasize that HP should be person‐centred approach and empathic communication. HP activities should be appealing, ludic and of proven effectiveness.ConclusionsAccording to a socio‐ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions.
Highlights
Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities
According to a socio-ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions
In recent years, primary care centre (PCC) workers and public health specialists have reflected on the need for HP and community health participation to tackle chronic diseases with an approach based on the biopsychosocial model and on social determinants of health.[3]
Summary
During the past 40 years, several institutions have proposed a shift in the health services towards health promotion (HP) with the aim to improve the health and well-being of populations. The objective of the EIRA study was to carry out and evaluate a complex, multirisk intervention designed for PHC patients aged 45-75 years, with the objective of developing health-promoting behaviours that improve the patients’ quality of life and prevent the most frequent chronic diseases and their potential complications.[16]. Taking into account the discourses of all stakeholders can be instrumental in increasing the motivation for participating in the study and can contribute strategies to facilitate recruitment and the adherence of health-care professionals and health-care users It can enhance acceptability, sustainability and adaptation of the intervention to each context. The objective of this study was to identify proposals to approach HP in the context of primary care according to health-care users, key community informants and PCC workers in seven Spanish regions. We aim to identify proposals to promote positive changes in behaviour related to nutrition, physical activity, smoking, mental health and cardiovascular risk
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