Anticipatory care and the role of Dutch general practice in health promotion — a critical reflection

Crebolder, H. F. J. M.; Horst, F. G. van der

doi:10.1016/0738-3991(96)00869-5

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…Many of these interventions were group based programs which also provided peer support to the participants [36,37,39-42,44-49,52]. Educating health professionals about the impact of health literacy on a range of behaviours is important if they are to be better able to support their patients to manage their health [20,22,89]. Many of the current tools to measure health literacy may be impractical for use as a screening tool in general practice but are useful as broad guidelines to help health professionals understand the impact of low health literacy on their patient’s health status [8].…”

Section: Discussionmentioning

confidence: 99%

“…However addressing health literacy and SNAPW risk factor management in general practice is difficult; the average consultation time with a GP is 7–8 min shorter than the time necessary to provide smoking cessation counselling [19]. The tyranny of the urgent means that people may only present to the GP when sick leaving little or no time for prevention [20-22]. …”

Section: Introductionmentioning

confidence: 99%

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Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis

et al. 2012

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BackgroundPeople with low health literacy may not have the capacity to self-manage their health and prevent the development of chronic disease through lifestyle risk factor modification. The aim of this narrative synthesis is to determine the effectiveness of primary healthcare providers in developing health literacy of patients to make SNAPW (smoking, nutrition, alcohol, physical activity and weight) lifestyle changes.MethodsStudies were identified by searching Medline, Embase, Cochrane Library, CINAHL, Joanna Briggs Institute, Psychinfo, Web of Science, Scopus, APAIS, Australian Medical Index, Community of Science and Google Scholar from 1 January 1985 to 30 April 2009. Health literacy and related concepts are poorly indexed in the databases so a list of text words were developed and tested for use. Hand searches were also conducted of four key journals. Studies published in English and included males and females aged 18 years and over with at least one SNAPW risk factor for the development of a chronic disease. The interventions had to be implemented within primary health care, with an aim to influence the health literacy of patients to make SNAPW lifestyle changes. The studies had to report an outcome measure associated with health literacy (knowledge, skills, attitudes, self efficacy, stages of change, motivation and patient activation) and SNAPW risk factor.The definition of health literacy in terms of functional, communicative and critical health literacy provided the guiding framework for the review.Results52 papers were included that described interventions to address health literacy and lifestyle risk factor modification provided by different health professionals. Most of the studies (71%, 37/52) demonstrated an improvement in health literacy, in particular interventions of a moderate to high intensity.Non medical health care providers were effective in improving health literacy. However this was confounded by intensity of intervention. Provider barriers impacted on their relationship with patients.ConclusionCapacity to provide interventions of sufficient intensity is an important condition for effective health literacy support for lifestyle change. This has implications for workforce development and the organisation of primary health care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis

et al. 2012

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“…Les médecins invoquent un manque de temps ainsi qu'un certain scepticisme quant à leur efficacité dans le conseil préventif[ (11,12]. Pourtant, celui-ci devrait faire partie de la pratique quotidienne et non s'inscrire uniquement dans le contexte d'un bilan de santé [13], car ce type de consultation occupe moins de 5% des consultations de médecine générale [14]. Notre étude montre que l'attente des patients face aux examens paracliniques est plus importante que celle recommandée par la médecine basée sur les preuves.…”

Section: Discussionunclassified

Le contrôle général de santé vu par les patients

2006

PrimaryCare (de)

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“…16,17 Integral to success was seeing patients as 'co-producers' of their health and it is this, coupled with a practitioner's knowledge of their patients' health, personal and social situations, that, for some, remain central to the approach of anticipatory care. [18][19][20] In a fragmented healthcare system, this approach may be difficult to replicate. 10 It is, however, possible to identify the active ingredients of an anticipatory care programme, regardless of setting (Box 1).…”

Section: Resultsmentioning

confidence: 99%

Delivering a national programme of anticipatory care in primary care: a qualitative study

O’Donnell

Mackenzie²,

Reid³

et al. 2012

Br J Gen Pract

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BackgroundPrimary prevention often occurs against a background of inequalities in health and health care. Addressing this requires practitioners and systems to acknowledge the contribution of health-related and social determinants and to deal with the lack of interconnectedness between health and social service providers. Recognising this, the Scottish Government has implemented a national programme of anticipatory care targeting individuals aged 45-64 years living in areas of socioeconomic deprivation and at high risk of cardiovascular disease. This programme is called Keep Well. AimTo explore the issues and tensions underpinning the implementation of a national programme of anticipatory care. Design and settingA qualitative study in five Wave 1 Keep Well pilot sites, located in urban areas of Scotland, and involving 79 general practices. MethodAnnual semi-structured interviews were conducted with 74 key stakeholders operating at national government level, local pilot level and within general practices, resulting in 118 interviews. Interview transcripts were analysed using the framework approach. ResultsFour underlying tensions were identified. First, those between a patient-focused generalpractice approach versus a population-level health-improvement approach, linking disparate health and social services; secondly, medical approaches versus wider social approaches; thirdly, a population-wide approach versus individual targeting; and finally, reactive versus anticipatory care. ConclusionImplementing an anticipatory care programme to address inequalities in cardiovascular disease identified several tensions, which need to be understood and resolved in order to inform the development of such approaches in general practice and to develop systems that reduce the degree of fragmentation across health and social services. Keywordsanticipatory care; cardiovascular diseases; inequalities, health; primary prevention. decisionmaking.

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Anticipatory care and the role of Dutch general practice in health promotion — a critical reflection

Cited by 10 publications

References 11 publications

Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis

Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis

Le contrôle général de santé vu par les patients

Delivering a national programme of anticipatory care in primary care: a qualitative study

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