Diseases In Primary Health Care Research Articles

The primary care in providing care for inflammatory bowel diseases: PEST analysis

Aim of the study. The study of macroeconomic (external) environmental factors influencing primary healthcare level as the main link in routing a patient with inflammatory bowel diseases and providing quality care.Materials and methods. The opinion of three experts on 4 groups of indicators (political, economic, social and technological) in the context of their impact on the outpatient level of care for inflammatory bowel diseases in the next 3-5 years is analyzed. All factors were taken into account based on the strength of their influence (from 1 to 3) and the probability of variability. Then, according to the methodology, a weight-adjusted score was determined.Results and discussion. The analysis of environmental factors on the effectiveness of medical care for inflammatory bowel diseases in primary health care has shown the importance of both technological factors (availability of information systems, telemedicine technologies, innovative techniques), political (related to the regulation of the health system at the Ministry level, the existing Standard, labor policy, the level of knowledge of doctors and preventive measures) and economic (financing of the system health care, developed infrastructure, income of the population and accessibility of services); socio-cultural factors are slightly less significant, primarily related to joint responsibility for the health of citizens, the level of education of the population, the degree of trust in medicine and the existing inflated expectations of patients with inflammatory bowel diseases.Conclusions. The analysis showed an obviously significant influence of technological, political and economic factors on the quality of care provided for inflammatory bowel diseases in primary health care. It is obvious that socio-cultural factors, primarily related to joint responsibility for the health of citizens, the level of education of the population, the degree of trust in medicine and the existing high expectations of patients with inflammatory bowel diseases, are comparatively less significant for the quality of care provided.

Feasibility and Determinants of Performance for a Tablet-Based Cognitive Assessment Tool in Rural and Urban Southeast Nigeria.

Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer's disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations. To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria. A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT. We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10-15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05). Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.

Self-care experience supported among people with chronic non-communicable diseases in primary health care

Objective: to highlight the knowledge of people with chronic non-communicable diseases about their experiences with supported self-care in the context of primary health care. Method: this is a qualitative exploratory study with 34 users, with hypertension and/or diabetes, in primary care, after implementing supported self-care for twelve months. Collection was through semi-structured interviews and textual data analysis was performed using the ALCESTE software, version 2018. Results: the corpus had a utilization rate of 76%, divided into three semantic classes: class 1: Dichotomy between attention person-centered and centered physician; class 2: Recognition of self-care in improving adherence to healthier behaviors; class 3: Appreciation of the applicability of the self-care plan. Final considerations: supported self-care demonstrates benefits, such as: greater adherence to behaviors that are fundamental to controlling and maintaining health, increased self-esteem and improved quality of life. However, it still revealed a strong influence of the medical-centered model and the need for greater investment in strategies to encourage self-management.

Medication Adherence in Adults with Chronic Diseases in Primary Healthcare: A Quality Improvement Project.

(1) Background: Medication adherence is influenced by a variety of intricate factors, presenting hurdles for nurses working to improve it among adults with chronic conditions. Pinpointing the reasons for non-adherence is crucial for customizing interventions. The objective of this quality improvement project was to improve medication adherence among adults with chronic diseases in primary healthcare by promoting evidence-based practices, identifying barriers and facilitators to compliance, and developing strategies to ensure optimal adherence through engaging the nursing team, enhancing knowledge, and evaluating the effectiveness of the implemented strategies. (2) Methods: This study was a quality improvement project that utilized the JBI Evidence Implementation framework, the Practical Application of Clinical Evidence System, and the Getting Research into Practice audit tool across three phases: (i) forming a project team and conducting a baseline audit, (ii) offering feedback via the GRiP tool, and (iii) conducting a follow-up audit to assess best practice outcomes. The study was conducted between September 2021 and March 2022 in the community care unit of Algarve Regional Health Administration, targeting adults with chronic illnesses. (3) Results: A total of 148 individuals were audited, including 8 nurses, 70 baseline patients, and 70 post-implementation patients. Initial compliance with key best practices was low, with several criteria at 0% compliance at baseline. Post-intervention, we observed significant improvements; compliance with key best practices improved dramatically, with many reaching 100%. Notable improvements included enhanced patient education on medication management, regular medication adherence assessments, and increased engagement of healthcare professionals in adherence activities. (4) Conclusions: This quality improvement project demonstrated that structured, evidence-based interventions could significantly enhance medication adherence among adults with chronic diseases. The success of the project highlights the potential of similar strategies to be applied broadly in primary healthcare settings to improve health outcomes.

Burden of Caregivers of Patients with Chronic Diseases in Primary Health Care: A Cross-Sectional Study in Greece.

In the world of elderly people and people with chronic diseases, caregivers give a solution to caring at home. This study aimed to evaluate the burden of caregivers of patients with chronic diseases in primary health care and identify possible demographic and other determinants of it. This was a cross-sectional study with a convenience sample, which was conducted in two health centers. The sample comprised 291 caregivers who visited the aforementioned health centers in Patra, Greece. A composite questionnaire was utilized: the first part included demographic data and care-related information and the second included the Zarit Burden Interview and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The highest mean score in the DASS was recorded in the depression subscale and the lowest in the stress subscale. Concerning the Zarit Burden Interview, the highest mean score was recorded in the personal strain subscale and the lowest in the management of care subscale. The highest correlation was recorded between role strain and anxiety and the lowest was between management of care and stress. Similarly, the total score in the Zarit Burden Interview correlated significantly (in a positive direction) with depression, anxiety, and stress. Most of the caregivers of patients with chronic diseases in primary health care experienced a moderate to severe burden (especially in the dimension of personal strain) and moderate depression. The experienced burden was positively associated with depression, anxiety, and stress. There were significant differences in the caregivers' burden according to several demographic and care-related characteristics.

Using spirometry for screening and diagnosis of chronic respiratory diseases in primary health care: findings from a community health project in rural India

Background Chronic respiratory diseases (CRDs) such as Chronic obstructive pulmonary disease (COPD), Asthma and post-tuberculosis lung disease (PTLD) are a growing public health concern in India. Early diagnosis and management of CRDs require a good quality spirometry test, a technician to conduct spirometry and a chest physician to interpret the results. In India, these are not available at the primary care level. This study reports the feasibility of a large-scale CRD diagnosis and management program in primary care using a unique point-of-care spirometry solution, Briota PFT in a Box™. # Methods A community-based cross-sectional study was conducted among 15,602 adults in Dindori Taluka (subdivision), Nashik, Maharashtra state. This study was part of a holistic CRD diagnosis and management program SAVE™ (Spirometry Assisted Virtually Early). Make In India point of care solution Briota PFT in a Box™ was used. A House‐to‐house community-based assessment checklist (CBAC) survey, 4-parameter spirometry test, 15-parameter pre and post-bronchodilator spirometry test and a software-assisted medical examination by the medical officer at primary care were conducted. Software was used to generate CRD diagnosis and lung health score (LHS™). The diagnosis was verified by the chest physician. Confirmed diagnosed patients were provided treatment and offered a patient support program. Interviews were conducted with the patients, nurses, doctors and public health officials for understanding feasibility and documenting learning from program SAVE™. # Results Out of 15,602 adults surveyed, total 4,937 (31.6%) were identified as “CRD high risk”. 1231 participants based on medical examination, spirometry tests and software analysis were identified as CRD candidates by medical officers at primary care. 1154 participants out of 15,602 (7.4%) were confirmed diagnosed as CRD patients post independent evaluation by chest physicians. At the time of follow-up, 537 patients (75% of 712 patients enrolled in patient support program) reported improvement in symptoms and high satisfaction with the program. District health officer, Medical officers, nurses, Accredited Social Health Activist (ASHA) from the primary health care centers confirmed ease of use and feasibility of using Briota PFT in a Box™ in program SAVE™. Outcome and learning from program SAVE™ was documented and submitted to Ministry of Health and Family Welfare Government of India. # Conclusions CRD diagnosis and management in large scale settings in primary healthcare level using a point of care spirometry solution Briota PFT in a Box™ is highly feasible.

Whole-course management of chronic obstructive pulmonary disease in primary healthcare: an internet of things-enabled prospective cohort study in China

BackgroundDespite substantial progress in reducing the global burden of chronic obstructive pulmonary disease (COPD), traditional methods to promote understanding and management of COPD are insufficient. We developed an innovative model...

Gastroesophageal reflux disease, obesity, bronchial asthma: simple combination or complex interaction

Gastroesophageal reflux disease (GERD) continues to be one of the most common diseases in primary health care. In recent years, the presence of several diseases in the same patient at the same time has been widely discussed. An increase in persons suffering from several chronic diseases is associated with a deterioration in the quality of life, a high risk of hospitalization and mortality, and taking into account the presence of co/poly/multimorbidity is necessary for decision-making when developing a patient management strategy in primary health care. Studies on GERD, obesity and bronchial asthma have shown that there are common and bidirectional mechanisms in the development of these diseases. And, there are many gaps in understanding these relationships, it is important to identify concomitant diseases, since they can be the cause of resistance to therapy, to form an unfavorable prognosis of their course.

Managing chronic obstructive pulmonary disease in primary health care: the impact of pulmonary rehabilitation

Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and its management involves improving quality of life, delaying progression, and minimizing exacerbations. The benefit of pulmonary rehabilitation in COPD has been documented in the literature. This intervention can be applied to a primary healthcare setting, using community resources. Objectives: This systematic review sought to compile current evidence implying the impact of pulmonary rehabilitation in a primary healthcare setting on the quality of life of patients with COPD. Methods: Three databases were searched for randomized controlled trials. We included community-based pulmonary rehabilitation and excluded interventions in a hospital setting. The primary outcome was health-related quality of life; secondary outcomes were functional exercise capacity and mortality. Data extraction and triage were performed independently by three authors, and bias was evaluated using the Cochrane Risk of Bias Tool. Results: Four studies met the search criteria. Three studies reported benefits in at least one of the outcomes; a fourth reported no differences between groups. Rehabilitation frequency and duration seemed to have some impact on all outcomes. Mortality was higher in the control groups when available. The included studies had important limitations, namely the inability to blind interventions. Conclusions: Pulmonary rehabilitation in a primary health care setting benefits the quality of life and functional exercise capacity in COPD patients. Optimal treatment modality, frequency, and duration are yet to be defined and are perhaps reliant on individual patient attributes. Though unable to add to previous findings, we hope this review fosters interest in this potentially life-changing intervention in a primary healthcare context.

THE DIFFERENCES OF MAXIMUM BLINK INTERVAL IN HYPERTENSION PATIENTS WITH AND WITHOUT DRY EYE DISEASE

Abstract&#x0D; Introduction &amp; Objectives : Hypertension and the use of antihypertensive drugs are thought to be one of the risk factors for dry eye disease due to a decrease in tear production. Maximum blink interval (MBI), which is the time during which the eye can remain unblinking, can be an easy method for assessing dry eye disease because local conditions in the eye can affect blinking patterns. This study aims to determine the difference in the average MBI in hypertensive patients with dry eye disease and hypertensive patients without dry eye disease.&#x0D; Methods : This study is a cross-sectional analytic study which was conducted in January 2022-June 2022. The sample of the study was hypertensive patients with dry eye disease and without dry eye disease who were treated at the Internal Medicine Polyclinic, Kidney-Hypertension Division at Sanglah Hospital (Prof I.G.N.G. Ngoerah Hospital). The sample selection technique was consecutive sampling and the total sample in the study was 81 people. Data were collected using the OSDI questionnaire and TBUT and Schirmer examinations to assess dry eye disease, blood pressure tests to assess hypertension, and MBI examination.&#x0D; Results : The results showed that the average MBI in hypertensive patients with dry eye disease twice shorter than in hypertensive patients without dry eye disease (p&lt;0.001).&#x0D; Conclusion : This shows that MBI can be used as a modality for screening and screening for dry eye disease in hypertensive patients. MBI can be an alternative for practitioners to objectively assess dry eye disease in primary health care where there is no complete ophthalmological facility.

Multimorbidity, Treatment, and Determinants among Chronic Patients Attending Primary Health Facilities in Tshwane, South Africa.

The growing burden of non-communicable diseases amidst the largest burden of HIV in South Africa leads to disease combinations of multimorbidity with the complexity of care. We conducted a cross-sectional study to assess multimorbidity, medication adherence, and associated factors among out-patients with chronic diseases in primary health care (PHC) facilities in Tshwane, South Africa. A structured questionnaire was used to collect data on comorbidities and medication adherence, along with socio-demographic and lifestyle factors. Logistic regression models were used to analyse the determinants of multimorbidity and medication adherence. In all 400 patients with chronic diseases (mean age: 47 ± 12 years) living in poor environments, common chronic conditions were hypertension (62%), diabetes (45%), HIV (44%), TB (33%), hypercholesterolemia (18%), and gout (13%). The proportion of concordant comorbidity (i.e., diseases with similar risk profiles and management) was 72%, more than 28% of discordant comorbidity (i.e., diseases not related in pathogenesis or management). Most patients had two coexisting chronic conditions (75%), while few had more than two chronic conditions (23%) and single-occurring conditions (2%). Prevalence rates for common multimorbidity patterns were 25% (HIV and TB), 17% (hypertension and diabetes), 9% (hypertension, diabetes, and hypercholesterolemia), and 2% (hypertension diabetes and HIV), while medication adherence was estimated at 74%. In multivariate analysis, multimorbidity was associated with an older age and lower socio-economic status, while medication non-adherence was associated with a younger age and socio-economic factors. The study highlights the presence of multimorbidity among primary care patients attributed to hypertension, diabetes, HIV, and TB in South Africa with non-adherence to medication in one-third of patients. Policies are needed for education on multimorbidity with a need to optimize lifestyle modifications, perhaps proactive outreach or nursing contact with high-risk patients with public-health-sensitive conditions, such as HIV and/or TB, as well as patients with a history of non-adherence to medications. Considerations should be given to the development of a medication adherence scale for multiple chronic conditions beyond assessing adherence to a single index medication.

Addressing Non-Communicable Diseases in Primary Healthcare in Kyrgyzstan: A Study on Population' Knowledge and Behavioral Changes.

Objective: Non-communicable diseases (NCDs) in Kyrgyzstan are responsible for 83% of all deaths. This study aimed to assess the effectiveness of WHO "Package of Essential Interventions on NCDs" (PEN) on health education and counselling at primary healthcare in Kyrgyzstan. Methods: Interventions consisted of information diffusion in primary care facilities and in communities by trained volunteers. The study aimed to assess the evolution of population's knowledge and behaviour through a questionnaire applying a quasi-experimental approach. The sample size was 2,000 at baseline and after 4years in intervention and control oblasts. Results: Population's knowledge and behaviour improved in intervention areas compared to control areas. Knowledge on NCD-related risks increased from 61% to 87%. Behaviour improved with physical activity increasing from 23% to 32%; smokers reduced from 22% to 20%; alcohol consumption reduced from 23% to 16%; daily walking (minimum 30') improved from 40% to 71%. Conclusion: This study suggests that the PEN-protocol is effective in improving healthy behaviour, thus potentially contributing to prevent NCDs. This example from Kyrgyzstan provides a practical example for promoting PEN-protocol adaptation in other countries.

Long-term tendency and risk factors for stroke in Bishkek

Objective: This retrospective study was designed to describe the morbidity, mortality rates and risk factors in adult urban population Bishkek, Kyrgyz Republic for the period 2004–2019 using data from the Stroke Registry. Methods: The data were derived from Stroke Registry between 2004 and 2019 in Bishkek through examination of records of patients admitted to hospitals and those receiving treatment at home prescribed by doctors of Registry. A retrospective epidemiological study of the long-term dynamics of the morbidity and mortality rates between 2004 and 2019 was performed. The growth (drawdown) rate was calculated using the least-squares method to align the time series. A comparative analysis of the rates was carried out by calculating the long-term average annual level of incidence by gender and age. Ethical approval was not necessary for the preparation of this article. Results: The most common type of stroke registered for the population of Bishkek was ischemic stroke (IS) (68.5%), followed by hemorrhagic stroke (HS) (21.4%) and cryptogenic stroke (10.1%). During the analyzed period of time there has been a moderate decrease in the incidence of IS (4,0%) and a notable decrease of HS (9,0%) and cryptogenic (26,9%) strokes. As for stroke mortality in long-term dynamics, we could observe an essential decrease in this indicator in all strokes (IS-13.0%, HS 13.6%, cryptogenic ones-37.7%). The most remarkable risk factor for stroke was arterial hypertension (86.5%). Cardiovascular pathology of another origin was detected in 32.7% of patients. Conclusion: Our results further help to understand what changes have been in the long-term dynamics of the incidence and mortality of stroke in Kyrgyzstan, in relation to which risk factors for stroke should be taken more action. There is a need to continue to strengthen prevention at the population level, to assess and manage the risk of cardiovascular disease in primary healthcare. Such measures will help prevent complications and support efforts to prevent relapse and disability.

Utilization of Injectable Drugs for Communicable and Non-communicable Diseases in Primary Healthcare: A Retrospective Study in Turkey

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) and “NCD” (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p&lt;0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections.

Management of Depression in Chronic Care Patients Using a Task-Sharing Approach in a Real-World Primary Health Care Setting in South Africa: Outcomes of a Cohort Study.

Depressive symptoms are common in South African primary care patients with chronic medical conditions, but are usually unrecognised and untreated. This study evaluated an integrated, task-sharing collaborative approach to management of depression comorbid with chronic diseases in primary health care (PHC) patients in a real-world setting. Existing HIV clinic counsellors provided a manualised depression counselling intervention with stepped-up referral pathways to PHC doctors for initiation of anti-depressant medication and/ or referral to specialist mental health services. Using a comparative group cohort design, adult PHC patients in 10 PHC facilities were screened with the Patient Health Questionnaire-9 with those scoring above the validated cut-off enrolled. PHC nurses independently assessed, diagnosed and referred patients. Referral for treatment was independently associated with substantial improvements in depression symptoms three months later. The study confirms the viability of task-shared stepped-up collaborative care for depression treatment using co-located counselling in underserved real-world PHC settings.

Remote digital monitoring for selected chronic diseases in primary health care

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of remote digital monitoring for adults with selected chronic diseases (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, congestive heart failure, and asthma) in primary healthcare settings.

Chinese guideline on the primary prevention of cardiovascular diseases in primary health care

心血管病是威胁我国人民生命和健康的重大公共卫生问题。实践证明，在心血管病事件发生之前，可以通过生活方式干预和危险因素防控等一级预防措施延缓或避免临床事件的发生。2020年，由中华医学会心血管病学分会牵头，联合相关学会共同制定了《中国心血管病一级预防指南》。为全面推进该指南的推荐建议在基层落地，推动“以治病为中心”向“以人民健康为中心”转移，专家工作组进一步结合基层心血管病防治的特点，给出有关心血管病风险评估、生活方式干预、血压管理、血脂管理、2型糖尿病管理和阿司匹林的使用等心血管病一级预防措施的推荐建议，并以问答形式进行解释说明。.

Medical outcomes study social support survey (MOS-SSS) in patients with chronic disease: A psychometric assessment.

Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables. A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS. Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory. The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.

Nursing protocol in chronic kidney disease prevention in older adults in primary care.

to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman's stressors. a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman's stressor concepts, NANDA, NIC, and NOC taxonomies, Risner's line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols. 102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified. the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman's stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.

Understanding factors affecting implementation success and sustainability of a comprehensive prevention program for cardiovascular disease in primary health care: a qualitative process evaluation study combining RE-AIM and CFIR.

Our aim was to evaluate the implementation process of a comprehensive cardiovascular disease prevention program in general practice, to enhance understanding of influencing factors to implementation success and sustainability, and to learn how to overcome barriers. Cardiovascular disease and its risk factors are the world's leading cause of mortality, yet can be prevented by addressing unhealthy lifestyle behavior. Nevertheless, the transition toward a prevention-oriented primary health care remains limited. A better understanding of factors facilitating or hindering implementation success and sustainability of prevention programs, and how barriers may be addressed, is needed. This work is part of Horizon 2020 project 'SPICES', which aims to implement validated preventive interventions in vulnerable populations. We conducted a qualitative process evaluation with participatory action research approach of implementation in five general practices. Data were collected through 38 semi-structured individual and small group interviews with seven physicians, 11 nurses, one manager and one nursing assistant, conducted before, during, and after the implementation period. We applied adaptive framework analysis guided by RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) and Consolidated Framework for Implementation Research (CFIR). Multiple facilitators and barriers affected reach of vulnerable target populations: adoption by primary health care providers, implementation and fidelity and intention to maintain the program into routine practice. In addition, our study revealed concrete actions, linked to implementation strategies, that can be undertaken to address identified barriers. Prioritization of prevention in general practice vision, ownership, and shared responsibility of all team members, compatibility with existing work processes and systems, expanding nurse's roles and upskilling competence profiles, supportive financial and regulatory frameworks, and a strong community - health care link are crucial to increase implementation success and long-term maintenance of prevention programs. COVID-19 was a major barrier to the implementation. RE-AIM QuEST, CFIR, and participatory strategies are useful to guide implementation of prevention programs in primary health care.