Beyond the consultation room: Proposals to approach health promotion in primary care according to health‐care users, key community informants and primary care centre workers

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.

Respect, trust and continuity: A qualitative study exploring service users’ experience of involvement at a Healthy Life Centre in Norway

“…Our findings showed that being respected, acknowledged and having a trustworthy relationship with the professionals were considered a prerequisite for the service users’ involvement in changing their health behaviour. This in line with other studies showing that user involvement is facilitated by a personal relationship, based on respect, collaboration and knowledge sharing . Similarly, Følling and colleagues found that HLC participants emphasized emotional support as essential to give them the courage to start and continue with healthy behaviour changes .…”

“…Because involvement of the service users is considered as essential in health promotion initiatives that encourage health behaviour change and aim to enable people to increase control over their health, it is important to address the service users’ own experiences of involvement.…”

Moving between ideologies in self‐management support—A qualitative study

“…Part of policy development involves decentralizing health‐promoting services from specialist care to primary care . It has previously been shown that it is difficult for primary care practitioners to focus on health promotion . One study suggests that health professionals strive to integrate the ideals of promotion, such as well‐being, but instead tend to focus on adherence to and compliance with medical advice .…”

“…It has previously been shown that it is difficult for primary care practitioners to focus on health promotion . One study suggests that health professionals strive to integrate the ideals of promotion, such as well‐being, but instead tend to focus on adherence to and compliance with medical advice . By focusing strictly on risk and disease prevention, health professionals often fail to broaden their aim towards more holistically inclusive and general health promotion .…”

“…Practices involved in chronic disease management settings may illustrate different sets of logics that may be coinciding or incompatible. Knowledge on how different practices in the health‐promoting field are incompatible or compatible is essential when countries are undergoing a change in orientation towards health promotion . Our aim is to investigate how health professionals perceive group‐based self‐management support and what logics they are drawing upon, within the context of focus group interviews.…”