Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners

Avendonk, M. J. P. van; Mensink, P. A. J. S.; Drenthen, A. J. M.; Binsbergen, J.J. van

doi:10.1093/fampra/cmr095

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…Commitment to change and innovation implementation behaviour has for example been explored in relation to employees’ trust in top management [ 51 ]. Research within the field of mental health [ 52 ] and within primary care has more extensively explored trust between patients and clinicians [ 53 ]. Consequently, trusting the messenger as part of change and/or of implementing guidelines has shown to be of importance between organisations and its individuals as well as between the individuals within the organisation.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis

et al. 2015

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BackgroundNational guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines.MethodsThe study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis.ResultsOur deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants’ perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context.ConclusionsOur findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.

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Section: Discussionmentioning

confidence: 99%

Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis

et al. 2015

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“…The title of the sixth Heelsum workshop: "Practice-based evidence for weight management: alliance between primary care and public health" (66,(110)(111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121)(122)(123)(124)(125)(126) recognizes both professor Green`s vision that we need more practice-based evidence (20) and the most important theme of the Heelsum workshops (weight management), as well as the need for an alliance between primary care and public health to fight overweight and obesity, and all its comorbidities (type 2 diabetes, metabolic syndrome, coronary heart disease, cancer) (59). Green et al gave four reasons for these alliances: most of the influences on weight management behaviour are beyond the control of primary care; they are not subject to the randomized controlled trial methods of evidence-based medicine; the ratio of intervention effort to impact does not favour clinical interventions; and physician support is needed for community intervention success (115).…”

Section: International Workhops Of the Heelsum Collaboration On Nutrmentioning

confidence: 99%

“…Van Avendonk et al discussed the introduction of the Dutch College of General Practitioners` guidelines for obesity and undernutrition (113). Guidelines like this one will be of great help to family doctors but will also be beneficial for the patient.…”

Section: International Workhops Of the Heelsum Collaboration On Nutrmentioning

confidence: 99%

Present and future of nutrition guidance : lifestyle advice in primary care

Hiddink¹,

Wass²

2016

Preprint

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“…In 71% of this subgroup, undernutrition was assessed by just looking at the patient and in only 5% a validated screening instrument was used [16]. The Dutch College of General Practitioners introduced the "National Primary Care Cooperation Agreement Undernutrition" on the collaboration of primary care workers in 2010 to enhance awareness and early intervention in the case of undernutrition [28]. Recognition of undernutrition in an early phase is important to initiate timely treatment and to prevent aggravation of the nutritional status.…”

Section: Introductionmentioning

confidence: 99%