Increasing community orientation of primary care health professionals: analysis of the training plan of a community health strategy.

backgroundImproving population health management requires moving beyond an individualistic and biologistic approach in primary care towards a more holistic perspective that considers the multiple elements interacting within a community. To this end, a Community Care Strategy in Aragón (Spain) was implemented, which has been acknowledged as a successful model by the WHO Regional Office for Europe. It guides primary care teams in the development of community care through three courses of action, built upon coordinated initiatives such as its multi-level training plan. This study aims to describe the characteristics of the professionals participating in the training plan, explore their perceived usefulness of the training, and examine its association with changes in daily primary care practice.

methodsA descriptive observational quantitative study was conducted, which analyzed the characteristics of the participating professionals in the training activities from 2017 to 2022. In order to assess the effectiveness and to determine its correlation with the degree of community involvement among professionals in their daily work, an online questionnaire was distributed to all the professionals who had participated in any training activity. The questionnaire also included two open-ended questions to gather qualitative insights into participants’ opinions regarding the training.

resultsDuring this period, a total of 1,107 places were offered in 38 continuing training activities. Participation in training activities related to each of the three courses of action of the strategy was significantly associated with their subsequent implementation in practice (OR 2.17 CI95% 1.39–3.4, OR 3.55 CI95% 2.08–6.06, and OR 1.62 CI95% 1.02–2.57). These associations were stronger among professionals who reported an increased community orientation following the training (OR 2.16 CI95% 1.13–4.11, OR 3.00 CI95% 1.55–5.83, and OR 3.70 CI95% 1.80–7.62).

conclusionsThe findings suggest that the continuing training plan of the Community Care Strategy is a valuable component in supporting the implementation of the strategy and enhancing the community orientation of primary care professionals. This shift aligns with a more community-oriented and salutogenic approach to primary care, consistent with WHO recommendations.