Implementation of the Family Nurse Partnership programme in England: experiences of key health professionals explored through trial parallel process evaluation

In Slovenia, the role of general practitioners in counselling physical activity for prevention of cardiovascular disease (CVD) is well recognized. The role of general practitioners in advising healthy lifestyle for individuals who are at risk of developing CVD is formally defined in the National Program for Primary Prevention of Cardiovascular Disease, which has been running since 2001. Part of the program is counselling on healthy lifestyle including physical activity, performed in all health centres across the country. First a screening and medical examination is performed. In case of higher risk for CVD (>20%) the physician should give advice on the particular risk factor and direct patients to health-education centres, where they can participate in healthy lifestyle workshops lead by health professionals. Physicians and other health professionals who are involved in the implementation of prevention activities within the program need knowledge and skills that are crucial for successful counselling on healthy lifestyle. The educational program “basic education in health promotion and prevention of chronic non-communicable diseases in primary health care/family medicine” consists of two parts. The first part of the training is open to all health professionals working within the program. The second part is intended for health professionals working in health-education workshops. In the last few years a new family practice model has been introduced and disseminated. Some duties of the family physician, including health promotion and counselling, are being transferred to graduate nurses who become part of the family practice team. This new division of work undoubtedly brings many advantages, both in terms of the work organization, and of high-quality patient care. Nevertheless preventive action cannot be fully passed on to graduate nurses. Careful planning and education are needed to ensure a comprehensive approach in healthy life style counselling.

Download Full-text

Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation

BMC Family Practice ◽

10.1186/s12875-021-01410-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Eva Seckler ◽

Verena Regauer ◽

Melanie Krüger ◽

Anna Gabriel ◽

Joachim Hermsdörfer ◽

...

Keyword(s):

Primary Care ◽

Data Collection ◽

Older People ◽

Process Evaluation ◽

Feasibility Study ◽

Health Professionals ◽

Implementation Strategy ◽

Care Pathway ◽

Main Trial ◽

Telephone Helpline

Abstract Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).

Download Full-text

Disclosure of Spousal Violence

Journal of Interpersonal Violence ◽

10.1177/0886260515585538 ◽

2016 ◽

Vol 32 (2) ◽

pp. 164-182 ◽

Cited By ~ 6

Author(s):

Hanan Al-Modallal

Keyword(s):

Health Professionals ◽

Spousal Violence ◽

Parental Violence ◽

Policy Makers ◽

Demographic Profile ◽

Significant Relationships ◽

Emotional Environment ◽

The Family ◽

Victims Of Violence ◽

Health Care Centers

The objectives of this study were to identify reasons behind not disclosing spousal violence and examine relationships between these reasons and women’s demographic profile including the experience of spousal violence. Jordanian women ( N = 709) aged 16 to 66 years ( M = 32.6, SD = 8.7) attending health care centers were recruited. Results indicated that women’s intentions to maintain the family unit and use of patience with abuser represented the top two reasons for not disclosing violence. Non-significant relationships were, generally, identified between not disclosing spousal violence and women’s demographic profile. Women’s justification of spousal violence and witnessing parental violence were the proposed reasons for women’s lack of disclosure of violence. Implications for this study include health professionals’ use of evidence-based knowledge and skills to deal with victims of violence. Researchers’ roles include creating physical and emotional environment that urges disclosure of violence. Furthermore, they can contribute with health professionals in the implementation of health education programs directing victims and perpetrators in the places where they can be located. Proper collaboration between health professionals, researchers, and policy makers may significantly limit suffering of victims of violence.

Download Full-text

Validation of instruments about family presence on invasive procedures and cardiopulmonary resuscitation in pediatrics

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.2368.3046 ◽

2018 ◽

Vol 26 (0) ◽

Author(s):

Cristiana Araújo Guiller Ferreira ◽

Flávia Simphronio Balbino ◽

Maria Magda Ferreira Gomes Balieiro ◽

Myriam Aparecida Mandetta

Keyword(s):

Cardiopulmonary Resuscitation ◽

Professional Practice ◽

Health Professionals ◽

Family Care ◽

University Hospital ◽

Invasive Procedures ◽

Family Presence ◽

The Family ◽

Good Internal Consistency

ABSTRACT Objective: to develop and validate instruments to identify health professionals’ beliefs related to the presence of the child’s family in invasive procedures and in cardiopulmonary resuscitation. Method: study based on Psychometrics to conduct the theoretical, empirical and analytical stages, developed in a neonatal unit of a university hospital. The two instruments were constructed based on the literature and applied to 96 health professionals. Results: the Cronbach’s Alpha of the instrument related to the professionals’ beliefson invasive procedures was 0.863 and the instrument on cardiopulmonary resuscitation was 0.882. In both instruments, the tests performed indicated a correlation between the items. From the factorial analysis, four factors were generated: (1) benefits of the presence of the family; (2) impairment for professional practice; (3) strategies for the inclusion of the family; and (4) limitation of learning and decision making by the professional. Conclusion: the instruments analyzed obtained a good internal consistency and are indicators of the professionals’ beliefs with the potential to evaluate the quality of family care in this context.

Download Full-text

Atuação dos profissionais de saúde da família frente ao trabalhador rural exposto a agrotóxicos / Performance of health professionals from the family front of the rural worker exposed to pesticides

Ciência Cuidado e Saúde ◽

10.4025/cienccuidsaude.v16i3.37051 ◽

2017 ◽

Vol 16 (3) ◽

Author(s):

Letícia Martins Machado ◽

Carmem Lúcia Colomé Beck ◽

Alexa Pupiara Flores Coelho ◽

Teresinha Heck Weiller ◽

Silviamar Camponogara

Keyword(s):

Health Professionals ◽

Rural Worker ◽

The Family

O objetivo foi conhecer a atuação dos profissionais de Estratégia Saúde da Família frente ao trabalhador rural exposto aos agrotóxicos. Foi adotado o delineamento qualitativo, descritivo. O estudo foi realizado com 15 profissionais de saúde de três Estratégias Saúde da Família. Os dados foram produzidos por meio de entrevista semiestruturada e submetidos à análise temática de conteúdo. Identificou-se que a atuação dos profissionais se restringia ao atendimento de problemas agudos dos usuários. O cuidado aos trabalhadores rurais era baseado na atenção curativista, com ênfase no alívio de sinais e sintomas de intoxicação. No âmbito preventivo, não se estabelecia fluxo de atendimento, não havendo ações planejadas e direcionadas à educação e sensibilização dos trabalhadores rurais em relação à exposição aos agrotóxicos. É possível concluir que a ruralidade não foi fator considerado no planejamento das ações nas Estratégias Saúde da Família. Para renovação da prática sugere-se a educação permanente, por meio da qual os profissionais de saúde possam se instrumentalizar teoricamente, para uma prática mais efetiva.

Download Full-text

Health professionals’ perspectives on exercise referral and physical activity promotion in primary care: Findings from a process evaluation of the National Exercise Referral Scheme in Wales

Health Education Journal ◽

10.1177/0017896914559785 ◽

2014 ◽

Vol 74 (6) ◽

pp. 743-757 ◽

Cited By ~ 29

Author(s):

Nafees U Din ◽

Graham F Moore ◽

Simon Murphy ◽

Clare Wilkinson ◽

Nefyn H Williams

Keyword(s):

Physical Activity ◽

Primary Care ◽

Process Evaluation ◽

Health Professionals ◽

Physical Activity Promotion ◽

Activity Promotion ◽

Exercise Referral ◽

Exercise Referral Scheme

Download Full-text

Cost-effectiveness of the Family Nurse Partnership (FNP) programme in England: Evidence from the building blocks trial

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.12799 ◽

2017 ◽

Vol 23 (6) ◽

pp. 1367-1374 ◽

Cited By ~ 7

Author(s):

Belen Corbacho ◽

Kerry Bell ◽

Eugena Stamuli ◽

Gerry Richardson ◽

Sarah Ronaldson ◽

...

Keyword(s):

Cost Effectiveness ◽

Building Blocks ◽

The Family ◽

Family Nurse Partnership

Download Full-text

Costs and consequences of the Family Nurse Partnership (FNP) programme in England: evidence from the Building Blocks trial

F1000Research ◽

10.12688/f1000research.20149.1 ◽

2019 ◽

Vol 8 ◽

pp. 1640 ◽

Cited By ~ 1

Author(s):

Kerry Bell ◽

Belen Corbacho ◽

Sarah Ronaldson ◽

Gerry Richardson ◽

Kerry Hood ◽

...

Keyword(s):

Home Visiting ◽

Controlled Trial ◽

Full Range ◽

Building Blocks ◽

Public Health Services ◽

Intervention Programme ◽

The Family ◽

Cost Consequence ◽

Implementation Costs ◽

Family Nurse Partnership

Background: The Family Nurse Partnership (FNP) is a licensed intensive home visiting intervention programme delivered to teenage mothers which was originally introduced in England in 2006 by the Department of Health and is now provided through local commissioning of public health services and supported by a national unit led by a consortium of partners. The Building Blocks (BB) trial aimed to explore the effectiveness and cost-effectiveness of this programme. This paper reports the results of an economic evaluation of the Building Blocks randomised controlled trial (RCT) based on a cost-consequence approach. Methods: A large sample of 1618 families was followed-up at various intervals during pregnancy and for two years after birth. A cost-consequence approach was taken to appraise the full range of costs arising from the intervention including both health and social measures of cost alongside the consequences of the trial, specifically, the primary outcomes. Results: A large number of potential factors were identified that are likely to attract additional costs beyond the implementation costs of the intervention including both health and non-health outcomes. Conclusion: Given the extensive costs and only small beneficial consequences observed within the two year follow-up period, the cost-consequence model suggests that the FNP intervention is unlikely to be worth the substantial costs and policy makers may wish to consider other options for investment. Trial registration: ISRCTN23019866 (20/04/2009)

Download Full-text