Latino Parents’ Experiences With Literacy Promotion in Primary Care: Facilitators and Barriers

The primary care network (PCN) was implemented as a healthcare delivery model which organises private general practitioners (GPs) into groups and furnished with a certain level of resources for chronic disease management. A secondary qualitative analysis was conducted with data from an earlier study exploring facilitators and barriers GPs enrolled in PCN’s face in chronic disease management. The objective of this study is to map features of PCN to Starfield’s “4Cs” framework. The “4Cs” of primary care—comprehensiveness, first contact access, coordination and continuity—offer high-quality design options for chronic disease management. Interview transcripts of GPs (n = 30) from the original study were purposefully selected. Provision of ancillary services, manpower, a chronic disease registry and extended operating hours of GP practices demonstrated PCN’s empowering features that fulfil the “4Cs”. On the contrary, operational challenges such as the lack of an integrated electronic medical record and disproportionate GP payment structures limit PCNs from maximising the “4Cs”. However, the enabling features mentioned above outweighs the shortfalls in all important aspects of delivering optimal chronic disease care. Therefore, even though PCN is in its early stage of development, it has shown to be well poised to steer GPs towards enhanced chronic disease management.

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Exploration of Barriers and Facilitators to Implementing Best Practice in Exercise Medicine in Primary Pediatric Care—Pediatrician Perspectives

Pediatric Exercise Science ◽

10.1123/pes.2020-0214 ◽

2021 ◽

pp. 1-8

Author(s):

Kim D. Lu ◽

Dan Cooper ◽

Raluca Dubrowski ◽

Melanie Barwick ◽

Shlomit Radom-Aizik

Keyword(s):

Primary Care ◽

Best Practice ◽

Barriers And Facilitators ◽

Pediatric Care ◽

Team Approach ◽

Implementation Barriers ◽

Primary Care Clinics ◽

Exercise Medicine ◽

Practice Variability ◽

Facilitators And Barriers

Purpose: Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians’ thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. Methods: The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. Results: Despite the pediatricians’ beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. Conclusion: The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.

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Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

Family Practice ◽

10.1093/fampra/cmab092 ◽

2021 ◽

Author(s):

Geertruida J Groenendijk-van Woudenbergh ◽

Marlies C van Hell-Cromwijk ◽

Ytje J J van der Veen ◽

Hylkje F Algra ◽

Willemieke Kroeze

Keyword(s):

Primary Care ◽

Communication Skills ◽

Healthy Eating ◽

Patient Encounter ◽

Structured Interviews ◽

Good Communication ◽

Practice Nurses ◽

Professional Characteristics ◽

Primary Care Patients ◽

Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

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Facilitators and barriers to utilization of medications for opioid use disorder in primary care in South Carolina

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217420946240 ◽

2020 ◽

Vol 56 (1) ◽

pp. 14-39

Author(s):

Sarah M Oros ◽

Lillian M Christon ◽

Kelly S Barth ◽

Carole R Berini ◽

Bennie L Padgett ◽

...

Keyword(s):

Primary Care ◽

South Carolina ◽

Focus Group ◽

Primary Care Providers ◽

Opioid Use Disorder ◽

Care Providers ◽

Opioid Use ◽

Focus Group Interviews ◽

Facilitators And Barriers ◽

Group Interviews

Objective Utilization of medications for opioid use disorder (MOUD) has not been widely adopted by primary care providers. This study sought to identify interprofessional barriers and facilitators for use of MOUD (specifically naltrexone and buprenorphine) among current and future primary care providers in a southeastern academic center in South Carolina. Method Faculty, residents, and students within family medicine, internal medicine, and a physician assistant program participated in focus group interviews, and completed a brief survey. Survey data were analyzed quantitatively, and focus group transcripts were analyzed using a deductive qualitative content analysis, based upon the theory of planned behavior. Results Seven groups ( N = 46) completed focus group interviews and surveys. Survey results indicated that general attitudes towards MOUD were positive and did not differ significantly among groups. Subjective norms around prescribing and controllability (i.e., beliefs about whether prescribing was up to them) differed between specialties and between level of training groups. Focus group themes highlighted attitudes about MOUD (e.g., “opens the flood gates” to patients with addiction) and perceived facilitators and barriers of using MOUD in primary care settings. Participants felt that although MOUD in primary care would improve access and reduce stigma for patients, prescribing requires improved provider education and an integrated system of care. Conclusions The results of this study provide an argument for tailoring education to specifically address the barriers primary care prescribers perceive. Results promote the utilization of active, hands-on learning approaches, to ultimately promote uptake of MOUD prescribing in the primary care setting in South Carolina.

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