Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses

Abstract

The methodological designs underpinning many primary health-care interventions are not rigorous. Logic models can be used to support intervention planning, implementation and evaluation in the primary health-care setting. Logic models provide a systematic and visual way of facilitating shared understanding of the rationale for the intervention, the planned activities, expected outcomes, evaluation strategy and required resources. This article provides guidance for primary health-care practitioners and researchers on the use of logic models for enhancing methodological rigour of interventions. The article outlines the recommended steps in developing a logic model using the 'NutriCare' intervention as an example. The 'NutriCare' intervention is based in the Australian primary health-care setting and promotes nutrition care by general practitioners and practice nurses. The recommended approach involves canvassing the views of all stakeholders who have valuable and informed opinions about the planned project. The following four targeted, iterative steps are recommended: (1) confirm situation, intervention aim and target population; (2) document expected outcomes and outputs of the intervention; (3) identify and describe assumptions, external factors and inputs; and (4) confirm intervention components. Over a period of 2 months, three primary health-care researchers and one health-services consultant led the collaborative development of the 'NutriCare' logic model. Primary health-care practitioners and researchers are encouraged to develop a logic model when planning interventions to maximise the methodological rigour of studies, confirm that data required to answer the question are captured and ensure that the intervention meets the project goals.

Using intervention mapping to develop an outpatient nursing nutritional intervention to improve nutritional status in undernourished patients planned for surgery

“…Nurses were found to be unaware of their roles and felt incapable of providing nutritional care (step 1). This is in accordance with other studies, which demonstrated that nurses were unaware of their nutritional roles, demonstrated low self-efficacy, and lacked nutritional knowledge [41,42] and education [43,44]. Since nutrition belongs to the core of basic nursing care [28,45,46], nurses need to be educated on their crucial roles regarding nutrition to ensure that patients are properly fed.…”

Investigating Whether the Mediterranean Dietary Pattern Is Integrated in Routine Dietetic Practice for Management of Chronic Conditions: A National Survey of Dietitians

“…In the context of limited public access to dietitians for chronic disease management, strategies for ongoing support to patients to implement long-term behaviour change required to sustain a MDP are needed. Enhanced use of technology and telehealth [76] as well as training of other primary care practitioners [77] could be useful strategies.…”

Evidence-Based Public Health Provided Through Local Health Departments: Importance of Academic–Practice Partnerships

“…[23][24][25][26] Similar approaches have been used in a range of disciplines and topics, from health systems development in post-conflict societies, 27 to exploring the association between nurse staffing levels and skill mix with patient safety and outcome, 28 and to enhancing the methodological quality of primary health-care interventions. 29 As more research is conducted on AHDs, we anticipate that our existing logic model can be further adapted, improved, and tested.…”