Staff perceptions of addressing lifestyle in primary health care: a qualitative evaluation 2 years after the introduction of a lifestyle intervention tool
Open accessAbstract
BACKGROUND: Preventive services and health promotion in terms of lifestyle counselling provided through primary health care (PHC) has the potential to reduce morbidity and mortality in the population. Health professionals in general are positive about and willing to develop a health-promoting and/or preventive role. A number of obstacles hindering PHC staff from addressing lifestyle issues have been identified, and one facilitator is the use of modern technology. When a computer-based tool for lifestyle intervention (CLT) was introduced at a number of PHC units in Sweden, this provided an opportunity to study staff perspectives on the subject. The aim of this study was to explore PHC staff's perceptions of handling lifestyle issues, including the consultation situation as well as the perceived usefulness of the CLT. METHODS: A qualitative study was conducted after the CLT had been in operation for 2 years. Six focus group interviews, one at each participating unit, including a total of 30 staff members with different professions participated. The interviews were designed to capture perceptions of addressing lifestyle issues, and of using the CLT. Interview data were analysed using manifest content analysis. RESULTS: Two main themes emerged from the interviews: a challenging task and confidence in handling lifestyle issues. The first theme covered the categories responsibilities and emotions, and the second theme covered the categories first contact, existing tools, and role of the CLT. Staff at the units showed commitment to health promotion/prevention, and saw that patients, caregivers, managers and politicians all have responsibilities regarding the issue. They expressed confidence in handling lifestyle-related conditions, but to a lesser extent had routines for general screening of lifestyle habits, and found addressing alcohol the most problematic issue. The CLT, intended to facilitate screening, was viewed as a complement, but was not considered an important tool for health promotion/prevention. CONCLUSION: Additional resources, for example in terms of manpower, may help to build the structures necessary for the health promotion/prevention task. Committed leaders could enhance the engagement among staff. Cooperation in multi-professional teams seems to be important, and methods or tools perceived by staff as compatible have a potential to be successfully implemented. Economic incentives rewarding quantity rather than quality appear to be frustrating to PHC staff.
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GPs and nurses often cited improving professional teamwork as a facilitator.
“GPs and nurses often cited improving professional teamwork (e.g. having a practice nurse delivering SBI, having receptionists giving patients screening tools) as a facilitator [39, 41, 54, 70, 71, 73, 76, 80, 91, 93, 97, 99].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [54]
In Results > Confidence in handling lifestyle issues (page unavailable), staff describe referrals to a lifestyle nurse or team as valuable, and GPs report confidence in nurses’ competence. This supports the teamwork aspect, but the paper does not establish that GPs and nurses often cited *improving* teamwork as a facilitator; the receptionist and SBI examples are not documented in the passages found. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn 10 qualitative studies, primary health care providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable.
“In 10 qualitative studies, primary health care (PHC) providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable [37, 41, 54, 77, 89, 91, 97, 99, 109, 115].”
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- Authors
- Carlfjord, S., Lindberg, M., & Andersson, A.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Carlfjord, Siw
- Venue
- BMC Family Practice
- Published
- 2012-10-10
- Volume
- 13
- Issue
- 1
- Pages
- 99-99
- ISSN
- 1471-2296 (ISSN-L)
- PMC
- PMC3515336
- OpenAlex
- W2157972882
- Cited by
- 32
- References
- 39
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 1 · 2013: 1
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Family Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Forskningsrådet i Sydöstra Sverige
- Forskningsrådet för Arbetsliv och Socialvetenskap
- Medical Research Council
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- lifestyle counseling, primary care, health promotion, preventive medicine, employee perceptions, alcohol screening, multidisciplinary team, economic incentives
- MeSH terms
- Attitude of Health Personnel, Female, Health Promotion, Humans, Life Style, Male, Patient Education as Topic, Preventive Medicine, Primary Health Care, Sweden, Therapy, Computer-Assisted, Focus Groups, Qualitative Research, Risk Reduction Behavior
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