‘The integration and training of the concept of Positive Health among health and social care professionals in an integrated community approach’ – defining the facilitators and barriers

Abstract

Introduction: Between 2016 and 2020 an Integrated Community Approach ICA as part of the pioneer site ‘Blue Care’ is implemented in four low SES neighbourhoods in Maastricht, located in the south of the Netherlands. Being one of nine pioneer sites across the Netherlands, ‘Blue Care’ aims to reduce healthcare costs, improve population health, improve the quality of care and improve the work satisfaction of professionals Quadruple Aim. To achieve this, the ICA follows the working principles of Positive Health health defined as the ability to adapt and self-manage. It will be the shared ideology among the stakeholders involved in the ICA directors; policymakers; professionals; providers of health and social care and citizens. The goal is to create a Positive Health movement, starting with training for health and social care professionals working in the four neighbourhoods. The research question is: What are the initial facilitators and barriers of health and social care professionals to integrate Positive Health into their daily working routines? Theory / Methods: Data was collected in 2017 and early 2018 by semi-structured interviews with directors/policymakers n=4, a digital evaluation form send after the Positive Health training to professionals n = 44, and focus groups with two multidisciplinary teams of professionals n=7 and n=8 two months after the training. Interviews and focus groups were audiotaped and transcribed verbatim. Conventional content analysis allowed themes to emerge from the data. The evaluation forms were analyzed using descriptive statistics. Results: Preliminary results show that having a shared ideology, which makes it easier to communicate between different professionals, is one of the main facilitators. At the same time, hesitance in prioritising the shared ideology of Positive Health and having different organizational performance measures are potential barriers. Importantly, professionals express the need for peer supervision to prevent relapse into old working routines. Discussion: Positive Health can be a worthwhile addition to the already existing work procedures, but full commitment of professionals as well as organizations is needed. Offering the professionals coaching-on-the-job might help to integrate the concept in daily working procedures. These aspects are deemed essential to make the integration of Positive Health sustainable. Conclusion: Preliminary results show that integrating Positive Health into working routines requires attention from the ICA coordination team and peer supervision. This is necessary to achieve a Positive Health movement in the four neigbourhoods. Lesson Learned: The adoption of a shared ideology goes beyond merely introducing a new concept to professionals. Full integration into daily working routines requires time and commitment by all professionals and organizations involved. Limitations: Data was collected at the starting phase of the ICA, hence the conclusion of how Positive Health is integrated in an ICA is not definitive yet. Suggestions: In future research it is important to focus on 1 the sustainability of Positive Health in daily working routines of professionals, as well as 2 the extent to which integration of Positive Health contributes to achieving the Quadruple Aim objectives.