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Vasiliou VS, Philia I, Drosatou C, Mitsi E, Tsakonas I. LeadinCare: A Qualitative Informed Digital Training Platform Development to Increase Physicians' Soft Communication Skills After COVID-19. PSYCHOL HEALTH MED 2024; 29:39-54. [PMID: 37131299 DOI: 10.1080/13548506.2023.2206144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
The post-COVID-19 pandemic era has placed new demands on physicians. One of these demands is the need to use targeted knowledge and soft communication skills, to address the psychosocial problems (e.g. vaccine hesitancy, fears) of individuals with Chronic Physical Illnesses (CPIs). Focusing on training physicians in targeted soft communication skills can help health care systems to address psychosocial-type problems. Yet, such training programs are rarely implemented, effectively.This study aimed to (a) understand physicians' implementation challenges when using soft communication skills during the COVID-19 pandemic; (b) identify beliefs, barriers, and facilitators that can influence physicians' behaviours to use soft communication skills; and (c) inform the content of the LeadinCare; a new digital training platform, designed to improve physicians' soft communication skills, by leveraging the TDF Theoretical Domain Framework (TDF).We conducted 14 in-depth semi-structured interviews with physicians in Greece, supporting non-COVID-19 cases with CPIs. We analyzed their data using inductive and deductive approaches.Physicians highlighted time, inability to see patients in person, absence of space for non-COVID-19 cases, and poor organizational procedures as barriers to using soft communication skills. Five TDF domains (beliefs) were identified as the most salient to inform the LeadinCare platform: (1) practical and well-organized knowledge; (2) skills that support patients and their relatives; (3) physicians' beliefs about capabilities to use the skills; (4) beliefs about consequences of using the skills (job satisfaction); and (5) the use of digital, interactive, and on-demand platforms (environmental context & resources). We mapped the domains in six narrative-based practices that informed the content of the LeadinCare.Physicians need skills that go beyond talking and towards cultivating resilience and flexibility.
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Affiliation(s)
- Vasilis S Vasiliou
- Postdoctoral Research Associate in Clinical and Health Psychology, Cardiff University, Cardiff, UK
- Clinical Psychologist & Postdoctoral Mixed Methods Research Associate, University of Oxford, Oxford, UK
| | - Issari Philia
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
| | - Constantina Drosatou
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
| | - Efi Mitsi
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
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Silva CS, Godinho C, Encantado J, Rodrigues B, Carraça EV, Teixeira PJ, Silva MN. Implementation determinants of physical activity interventions in primary health care settings using the TICD framework: a systematic review. BMC Health Serv Res 2023; 23:1082. [PMID: 37821932 PMCID: PMC10568782 DOI: 10.1186/s12913-023-09881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/07/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Translation into practice of effective physical activity interventions in primary care is difficult, due to a complex interaction of implementation determinants. We aimed to identify implementation barriers and facilitators of four primary care interventions: physical activity assessment, counselling, prescription, and referral. METHODS A systematic review of qualitative, quantitative and mixed-methods studies published since 2016 was conducted. The "Tailored Implementation for Chronic Diseases" (TICD) framework was adapted to extract and synthesize barriers and facilitators. RESULTS Sixty-two studies met the inclusion criteria. Barriers (n = 56) and facilitators (n = 55) were identified across seven domains, related to characteristics of the intervention, individual factors of the implementers and receivers, organizational factors, and political and social determinants. The five most frequently reported determinants were: professionals' knowledge and skills; intervention feasibility/compatibility with primary health care routine; interventions' cost and financial incentives; tools and materials; and professionals' cognitions and attitudes. "Social, political and legal factors" domain was the least reported. Physical activity counselling, prescription, and referral were influenced by determinants belonging to all the seven domains. CONCLUSION The implementation of physical activity interventions in primary care is influenced by a broader range of determinants. Barriers and facilitators related with health professionals, intervention characteristics, and available resources were the most frequently reported. A deep understanding of the local context, with particularly emphasis on these determinants, should be considered when preparing an intervention implementation, in order to contribute for designing tailored implementation strategies and optimize the interventions' effectiveness.
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Affiliation(s)
- Catarina Santos Silva
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.
- Programa Nacional Para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisboa, Portugal.
| | - Cristina Godinho
- Programa Nacional Para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisboa, Portugal
| | - Jorge Encantado
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Bruno Rodrigues
- CIAFEL, Faculdade de Desporto da Universidade Do Porto, Porto, Portugal
| | - Eliana V Carraça
- CIDEFES, Centro de Investigação em Desporto, Educação Física, Exercício e Saúde, Universidade Lusófona, Lisboa, Portugal
| | - Pedro J Teixeira
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Marlene Nunes Silva
- Programa Nacional Para a Promoção da Atividade Física, Direção-Geral da Saúde, Lisboa, Portugal
- CIDEFES, Centro de Investigação em Desporto, Educação Física, Exercício e Saúde, Universidade Lusófona, Lisboa, Portugal
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Woodhead G, Sivaramakrishnan D, Baker G. Promoting physical activity to patients: a scoping review of the perceptions of doctors in the United Kingdom. Syst Rev 2023; 12:104. [PMID: 37355661 PMCID: PMC10290366 DOI: 10.1186/s13643-023-02245-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/24/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND The physician-patient encounter presents an ideal opportunity for physical activity (PA) promotion. This review aims to (i) explore the breadth and depth of existing literature investigating doctors' perceptions of PA promotion in the United Kingdom (UK) and (ii) identify factors influencing the extent to which doctors engage in PA promotion during patient interactions. METHODS A five-stage scoping review methodology and the PRISMA-ScR guidance were followed: Stage 1-research questions specified; Stage 2-relevant studies identified by searching five electronic databases and manual screening of references; Stage 3-studies screened using Covidence™; Stage 4-study data extracted and charted; and Stage 5-findings from included studies were analysed, summarised and reported using (i) descriptive numerical analysis to provide insight into study characteristics and (ii) narrative summary of the evidence categorised by factors that influence doctors' engagement with PA promotion. RESULTS In total, 16,961 studies were screened. Nineteen studies were included in the review with most conducted in primary care focusing on the perceptions of general practitioners. Seven influencing factors were identified: knowledge and training, personal interest and PA level, time, resources, confidence, the perceived role of the doctor and patient relevance. CONCLUSION This review provides new evidence that historical barriers and influencing factors have a persisting impact on the ability and willingness of UK doctors to engage with PA promotion with patients. Previous efforts to address these factors would appear to have had limited success. Further intervention efforts are required to ensure more widespread and effective PA promotion to patients.
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Affiliation(s)
- Gemma Woodhead
- Edinburgh Medical School, University of Edinburgh, Scotland, UK
| | - Divya Sivaramakrishnan
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Sciences, University of Edinburgh, Scotland, UK
| | - Graham Baker
- Physical Activity for Health Research Centre, Moray House School of Education & Sport, University of Edinburgh, Scotland, UK.
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O’Rourke R, Lima ML, Jetten J. Healthcare professionals and medical cannabis: a scoping review informed by the theoretical domains framework. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01624-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Wit RF, Lucassen DA, Beulen YH, Faessen JPM, Bos-de Vos M, van Dongen JM, Feskens EJM, Wagemakers A, Brouwer-Brolsma EM. Midwives' Experiences with and Perspectives on Online (Nutritional) Counselling and mHealth Applications for Pregnant Women; an Explorative Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6733. [PMID: 34201452 PMCID: PMC8267613 DOI: 10.3390/ijerph18136733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022]
Abstract
Prenatal nutrition is a key predictor of early-life development. However, despite mass campaigns to stimulate healthy nutrition during pregnancy, the diet of Dutch pregnant women is often suboptimal. Innovative technologies offer an opportunity to develop tailored tools, which resulted in the release of various apps on healthy nutrition during pregnancy. As midwives act as primary contact for Dutch pregnant women, the goal was to explore the experiences and perspectives of midwives on (1) nutritional counselling during pregnancy, and (2) nutritional mHealth apps to support midwifery care. Analyses of eleven in-depth interviews indicated that nutritional counselling involved the referral to websites, a brochure, and an app developed by the Dutch Nutrition Centre. Midwives were aware of the existence of other nutritional mHealth apps but felt uncertain about their trustworthiness. Nevertheless, midwives were open towards the implementation of new tools providing that these are trustworthy, accessible, user-friendly, personalised, scientifically sound, and contain easy-digestible information. Midwives stressed the need for guidelines for professionals on the implementation of new tools. Involving midwives early-on in the development of future nutritional mHealth apps may facilitate better alignment with the needs and preferences of end-users and professionals, and thus increase the likelihood of successful implementation in midwifery practice.
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Affiliation(s)
- Renate F. Wit
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
| | - Desiree A. Lucassen
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
| | - Yvette H. Beulen
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
- Health and Society, Department of Social Sciences, Wageningen University and Research, P.O. Box 8130, 6700 EW Wageningen, The Netherlands;
| | - Janine P. M. Faessen
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
| | - Marina Bos-de Vos
- Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE Delft, The Netherlands;
| | - Johanna M. van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands;
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
| | - Annemarie Wagemakers
- Health and Society, Department of Social Sciences, Wageningen University and Research, P.O. Box 8130, 6700 EW Wageningen, The Netherlands;
| | - Elske M. Brouwer-Brolsma
- Division of Human Nutrition and Health, Department Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands; (R.F.W.); (D.A.L.); (Y.H.B.); (J.P.M.F.); (E.J.M.F.)
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Connecting primary care patients to community-based physical activity: a qualitative study of health professional and patient views. BJGP Open 2020; 4:bjgpopen20X101100. [PMID: 32694135 PMCID: PMC7465571 DOI: 10.3399/bjgpopen20x101100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/20/2020] [Indexed: 11/06/2022] Open
Abstract
Background Inconclusive evidence supporting referrals from health professionals to gym-based exercise programmes has raised concern for the roll-out of such schemes, and highlights the importance of developing links between healthcare settings and community-based opportunities to improve physical activity (PA) levels. Aim This study aimed to identify methods, and explore barriers and facilitators, of connecting primary care patients with PA opportunities from the perspectives of both health professionals (HPs) and patients, using the example of jogscotland. Design & setting An exploratory study utilising semi-structured interviews with primary care patients (n = 14) and HPs (n = 14) from one UK NHS board was conducted. Method Patient and HP transcripts were analysed separately using thematic analysis. Potential methods of connection were identified. The Capability, Opportunity, Motivation, behavioural (COM-B) model and theoretical domains framework (TDF) were employed to facilitate identification of barriers and facilitators for connecting primary care to community jogscotland groups. Results Three methods of connecting patients to community-based groups were identified: informal passive signposting, informal active signposting, and formal referral or prescribing. Barriers and facilitators for patient connection fell into five TDF domains for HPs and two COM-B model components for patients. Conclusion For patients, HPs raising the topic of PA can help to justify, facilitate, and motivate action to change. The workload associated with connecting patients with community-based opportunities is central to implementation by HPs. Integrative resource solutions and social support for patients can provide a greater variety of PA options and the vital information and support for connecting with local opportunities, such as jogscotland.
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