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Pola-Garcia M, Carrera Noguero AM, Astier-Peña MP, Mira JJ, Guilabert-Mora M, Cassetti V, Melús-Palazón E, Gasch-Gallén A, Benedé Azagra CB. Social Prescribing Schemes in Primary Care in Spain (EvalRA Project): a mixed-method study protocol to build an evaluation model. BMC Prim Care 2023; 24:220. [PMID: 37880601 PMCID: PMC10598937 DOI: 10.1186/s12875-023-02164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/28/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. METHODS In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. DISCUSSION Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.
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Affiliation(s)
- M Pola-Garcia
- Servicio Aragonés de Salud, Zaragoza, Spain.
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
| | - A M Carrera Noguero
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Programa Actividades Comunitarias en Atención Primaria (PACAP), Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
| | - M P Astier-Peña
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Unidad Territorial de Calidad, Dirección Territorial del Camp de Tarragona, Institut Català De La Salut, Tarragona, Spain
- FEPS, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Wonca World Executive Board, Brussels, Belgium
- Grupo de trabajo de Seguridad del Paciente, Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
| | - J J Mira
- Departmento Psicología de la Salud, Universidad Miguel Hernandez, Alicante, Spain
- Grupo de Investigación Atenea, Fundación para la Investigación Biomédica de la Comunidad Valenciana (FISABIO), Alicante, Spain
- Calité Investigación, Universidad Miguel Hernandez, Alicante, Spain
- Departamento de Salud Alicante-San Juan de Alicante, Alicante, Spain
| | - M Guilabert-Mora
- Departmento Psicología de la Salud, Universidad Miguel Hernandez, Alicante, Spain
- Calité Investigación, Universidad Miguel Hernandez, Alicante, Spain
| | - V Cassetti
- Universidad Internacional de Valencia (VIU), Valencia, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Indepent research, Affiliated researcher to the Unesco Chair in Global Health and Education, London, UK
| | - E Melús-Palazón
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Medicina, Psiquiatría y Dermatología, Universidad de Zaragoza, Zaragoza, Spain
| | - A Gasch-Gallén
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Fisiatria y Enfermería, Universidad de Zaragoza, Zaragoza, Spain
- Grupo GIIS094, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - C B Benedé Azagra
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Programa Actividades Comunitarias en Atención Primaria (PACAP), Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Estrategia de Atencion Comunitaria en el Sistema de Salud de Aragon Atencion Primaria. Servicio Aragones de Salud, Departamento de Sanidad, Gobierno de Aragon, Zaragoza, Spain
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Cassetti V, López-Ruiz MV, Domínguez M, Gallego-Royo A, García AM, Gea-Caballero V, Nuñez C, Paredes-Carbonell JJ, Pérula-De Torres LA, Pola-Garcia M, Benedé Azagra CB. Evaluating the implementation of community engagement guidelines (EVALUA GPS project): a study protocol. BMJ Open 2023; 13:e062383. [PMID: 36822807 PMCID: PMC9950881 DOI: 10.1136/bmjopen-2022-062383] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION The EVALUA GPS project aims to evaluate the impact of the implementation of the National Institute for Health Care and Excellence (NICE) guideline 'Community engagement: improving health and well-being and reducing health inequalities' adapted to the Spanish context. METHODS AND ANALYSIS Phase I: A tool will be designed to evaluate the impact of implementing the recommendations of the adapted NICE guideline. The tool will be developed through a review of the literature on implementation of public health guidelines between 2000 and 2021 and an expert's panel consensus. PHASE II The developed tool will be implemented in 16 community-based programmes, acting as intervention sites, and 4 controls through a quasi-experimental pre-post study. Phase III: A final online web tool, based on all previously collected information, will be developed to support the implementation of the adapted NICE guidelines recommendations in other contexts and programmes. DATA COLLECTION AND ANALYSIS Data will be collected through surveys and semistructured interviews. Quantitative and qualitative data will be analysed to identify implementation scenarios, changes in community engagement approaches, and barriers and facilitators to the implementation of the recommendations. All this information will be further synthesised to develop the online tool. ETHICS AND DISSEMINATION The proposed research has been approved by the Clinical Research Ethics Committee of Aragon. Results will be presented at national and international conferences and published in peer-reviewed open access journals. The interactive online tool (phase III) will include examples of its application from the fieldwork.
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Affiliation(s)
| | - María Victoria López-Ruiz
- Government of Andalusia Andalusian Health Service, Sevilla, Spain
- Instituto Maimonides de Investigacion Biomedica de Cordoba, Cordoba, Spain
| | - Marta Domínguez
- Health Research Institute Aragón, Zaragoza, Spain
- Servicio Aragones de Salud, Zaragoza, Spain
| | - Alba Gallego-Royo
- Health Research Institute Aragón, Zaragoza, Spain
- Servicio Aragones de Salud, Zaragoza, Spain
| | | | - Vicente Gea-Caballero
- Faculty of Health Science, Valencian International University, Valencia, Spain
- Research Group in Community Health and Care SALCOM, Valencian International University, Valencia, Spain
| | - Catalina Nuñez
- Health Promotion Service, General Directorate of Public Health, Balearic Islands, Spain
| | | | - Luis Angel Pérula-De Torres
- Instituto Maimonides de Investigacion Biomedica de Cordoba, Cordoba, Spain
- Teaching Unit of Family and Community Medicine, Health District of Cordoba and Guadalquivir, Cordoba, Spain
| | - Marina Pola-Garcia
- Health Research Institute Aragón, Zaragoza, Spain
- Servicio Aragones de Salud, Zaragoza, Spain
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Pola-Garcia M, Domínguez García M, Gasch-Gallén Á, Lou Alcaine ML, Enríquez Martín N, Benedé Azagra CB. [Implementation of a social prescribing protocol in Aragon's primary care teams]. Aten Primaria 2022; 54:102496. [PMID: 36308979 PMCID: PMC9614823 DOI: 10.1016/j.aprim.2022.102496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To analyze the implementation of social prescribing guideline in primary care Aragón. DESIGN Observational, descriptive, cross-sectional study. LOCATION One hundred twenty-three primary care teams of Aragón. PARTICIPANTS Social prescribing made with the protocol «Recomendación Activos - AP» of electronic health record of primary care Aragón from September 2018 to March 2021. MAIN MEASUREMENTS The most relevant variables of the protocol were described: age, sex, province, health sector, basic health area, health problem, aspect to be enhanced, asset for health recommended, type of professional, degree of assistance, satisfaction and improvement. RESULTS The protocol was used 2109 times, 1482 recommendations were made and 428 follow-ups were performed. The use of the protocol increased progressively until March 2020. A total of 1431 people received one recommendation and 51 received more than one recommendation. The average age of the beneficiaries was 67.9years. 74.8% of recommendations were addressed to women. Diagnoses related to social and psychological problems were the most frequently recommended, and the physical sphere was the aspect most promoted. Most social prescribing was linked to physical activity and resources for the promotion of personal autonomy. More than 90% of the people regularly attended the activity, the average satisfaction was 4.8 (0/5) and the degree of improvement 4.3 (0/5). CONCLUSIONS The implementation of asset for health recommended within the Aragon community care strategy is working, however, some aspects need to be reviewed. It is necessary to continue generating evidence to be able to adapt and make this process more efficient.
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Affiliation(s)
- Marina Pola-Garcia
- Centro de Salud Almozara, Sector Zaragoza II, Servicio Aragonés de Salud, Zaragoza, España,Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, España,Autor para correspondencia.
| | - Marta Domínguez García
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, España,Centro de Salud Calatayud Sur, Sector Calatayud, Servicio Aragonés de Salud, Calatayud, Zaragoza, España,Grupo de Investigación en Atención Primaria B21_20R, Gobierno de Aragón, Zaragoza, España,Programa Actividades Comunitarias en Atención Primaria de Aragón (PACAP Aragón), Sociedad Aragonesa Medicina Familiar y Comunitaria (SAMFYC), Zaragoza, España
| | - Ángel Gasch-Gallén
- Grupo de Investigación en Atención Primaria B21_20R, Gobierno de Aragón, Zaragoza, España,Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España,Grupo GIIS094, Instituto de Investigación Sanitaria de Aragón, Zaragoza, España
| | - María Luz Lou Alcaine
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, España,Dirección General de Asistencia Sanitaria, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, España
| | - Natalia Enríquez Martín
- Unidad de Calidad y Seguridad, Servicio Aragonés de Salud, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, España
| | - Carmen Belén Benedé Azagra
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, España,Grupo de Investigación en Atención Primaria B21_20R, Gobierno de Aragón, Zaragoza, España,Programa Actividades Comunitarias en Atención Primaria de Aragón (PACAP Aragón), Sociedad Aragonesa Medicina Familiar y Comunitaria (SAMFYC), Zaragoza, España,Centro de Salud Canal Imperial, Sector Zaragoza II, Servicio Aragonés de Salud, Zaragoza, España
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Cassetti V, Victoria López-Ruiz M, Pola-Garcia M, García AM, Josep Paredes-Carbonell J, Angel Pérula-De Torres L, Belén Benedé-Azagra C. An integrative review of the implementation of public health guidelines. Prev Med Rep 2022; 29:101867. [PMID: 35879936 PMCID: PMC9307457 DOI: 10.1016/j.pmedr.2022.101867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
The evidence on public health guidelines implementation is scarce. Most implementation of public health guidelines centres on individuals’ behaviour. Most evaluations of public health guidelines focus on barriers to implementation.
Health guidelines are important tools to ensure that health practices are evidence-based. However, research on how these guidelines are implemented is scarce. This integrative review aimed to: identify the literature on evaluation of public health guidelines implementation to explore (a) the topics which public health guidelines being implemented and evaluated in their implementation process are targeting; (b) how public health guidelines are being translated into action and the potential barriers and facilitators to their implementation; and (c) which methods are being used to evaluate their implementation. A total of 2001 articles published since 2000 and related to both clinical and public health guidelines implementation was identified through searching four databases (PubMed, CINAHL, Web of Science, Scopus). After screening titles and abstracts, only 10 papers related to public health guidelines implementation, and after accessing full-text, 8 were included in the narrative synthesis. Data were extracted on: topic and context, implementation process, barriers and facilitators, and evaluation methods used, and were then synthesised in a narrative form using a thematic synthesis approach. Most of these studies focussed on individual behaviours and targeted specific settings. The evaluation of implementation processes included qualitative, quantitative and mixed-methods. The few articles retrieved suggest that evidence is still limited and highly context specific, and further research on translating public health guidelines into practice is needed.
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Affiliation(s)
- Viola Cassetti
- Independent Researcher, Spain.,Community Activities Program in Primary Care (PACAP), Spanish Society for Family and Community Medicine (semFYC), Spain
| | - María Victoria López-Ruiz
- Community Activities Program in Primary Care (PACAP), Spanish Society for Family and Community Medicine (semFYC), Spain.,Castilla del Pino Primary Care Center, Andalusian Health Service, Spain.,Maimonides Institute for Biomedical Research of Cordoba (GICEAP-IMIBIC)/ Reina Sofía Hospital / University of Cordoba, Spain
| | - Marina Pola-Garcia
- Almozara Primary Care Center, Aragon Health Service, Spain.,GIIS 011 Primary Care Research Group, Aragon Health Research Institute (IIS), Spain
| | - Ana M García
- Department of Preventive Medicine and Public Health, University of Valencia, Spain.,CIBERESP, Madrid, Spain
| | - Joan Josep Paredes-Carbonell
- Community Activities Program in Primary Care (PACAP), Spanish Society for Family and Community Medicine (semFYC), Spain.,Primar Care Management, Health Departement La Ribera, Valencian Community, Spain
| | - Luis Angel Pérula-De Torres
- Maimonides Institute for Biomedical Research of Cordoba (GICEAP-IMIBIC)/ Reina Sofía Hospital / University of Cordoba, Spain.,Multiprofessional Teaching Unit for Family and Community Care of the Córdoba and Guadalquivir District, Spain
| | - Carmen Belén Benedé-Azagra
- Community Activities Program in Primary Care (PACAP), Spanish Society for Family and Community Medicine (semFYC), Spain.,GIIS 011 Primary Care Research Group, Aragon Health Research Institute (IIS), Spain.,Canal Imperial-San José Sur Primary Care Center, Aragon Health Service, Spain.,Government of Aragon Consolidated Research Group in Primary Care, Spain
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