Evidence map›Paper›PMID 37715160›Full record

ArticleBMC health services research2023

Process evaluation of an implementation intervention to facilitate the use of the Swedish Physical Activity on Prescription in primary healthcare.

Catharina Gustavsson, Maria Nordqvist, Åsa Bergman Bruhn, Kristina Bröms, Lars Jerdén, Lena V Kallings, Lars Wallin

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Catharina GustavssonCenter for Clinical Research Dalarna, Uppsala University, Nissers Vag 3, 79182, Falun, Sweden. catharina.gustavsson@regiondalarna.se.ORCID http://orcid.org/0000-0002-8709-4446
Maria NordqvistCenter for Clinical Research Dalarna, Uppsala University, Nissers Vag 3, 79182, Falun, Sweden.
Åsa Bergman BruhnSchool of Health and Welfare, Dalarna University, 79188, Falun, Sweden.ORCID http://orcid.org/0000-0002-6345-1656
Kristina BrömsDepartment of Public Health and Caring Sciences, Uppsala University, BMC, Box 564, 751 22, Uppsala, Sweden.ORCID http://orcid.org/0000-0002-0080-5023
Lars JerdénCenter for Clinical Research Dalarna, Uppsala University, Nissers Vag 3, 79182, Falun, Sweden.ORCID http://orcid.org/0000-0001-6549-1611
Lena V KallingsDepartment of Public Health and Caring Sciences, Uppsala University, BMC, Box 564, 751 22, Uppsala, Sweden.ORCID http://orcid.org/0000-0002-3185-9702
Lars WallinSchool of Health and Welfare, Dalarna University, 79188, Falun, Sweden.ORCID http://orcid.org/0000-0001-9035-0669
Dalarna University · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Swedish Physical Activity on Prescription (PAP-S) is a method for healthcare to promote physical activity for prevention and treatment of health disorders. Despite scientific support and education campaigns, the use has been low. The aim of this study was to perform a process evaluation of an implementation intervention targeting the use of the PAP-S method in primary healthcare (PHC). Specifically, we wanted to evaluate feasibility of the implementation intervention, and its effect on the implementation process and the outcome (number of PAP-S prescriptions).

methodsThis was a longitudinal study using the Medical Research Council guidance for process evaluation of a 9-month implementation intervention among healthcare staff at three PHC centres in Sweden. Data was collected by: participatory observations of the implementation process; questionnaires to the staff before, after and 6 months after the implementation intervention; interviews after the implementation intervention; and number of PAP-S prescriptions.

resultsDuring the implementation intervention, the workplaces' readiness-to-change and the healthcare staff's confidence in using the PAP-S method were favourably influenced, as was the number of PAP-S prescriptions. After the implementation intervention, the number of PAP-S prescriptions decreased to about the same number as before the implementation intervention, at two out of three PHC centres. Four of the six implementation strategies appeared to impact on the implementation process: external facilitation; leadership engagement by a committed workplace management; local PAP-S coordinator taking a leading role and acting as local champion; educational outreach concerning how to use the PAP-S method.

conclusionThe implementation intervention was not sufficient to produce sustained change of the healthcare staff's behaviour, nor did it achieve favourable long-term outcome on the number of PAP-S prescriptions. The healthcare staffs' sparse knowledge of the PAP-S method prior to the implementation intervention hampered the implementation. More hands-on education in how to use the PAP-S method introduced early in the implementation process is imperative for successful implementation of the PAP-S method. The findings also suggest that committed workplace management and local PAP-S coordinators, taking leading roles and acting as local champions, need to be firmly established at the PHC centres before the external facilitator withdraws.

trial registrationRegistered in the ISRCTN registry with study registration number: ISRCTN15551042 (Registration date: 12/01/2016).

Indexed as

ExercisePrescriptionsHumansLongitudinal StudiesPrimary Health CareSwedenDisease preventionExerciseHealth professionalsHealth promotionImplementationMixed methods research

Identifiers

PMID37715160
PMCPMC10504760
OpenAlexW4386770302

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.