Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals

Abstract

Objective

Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professionals on supporting change was explored.

Design

This study had an explorative qualitative design using data gathered from individual interviews and focus groups. Qualitative content analysis with a deductive category development was applied using the Consolidated Framework for Implementation Research.

Setting and participants

The study was conducted in a primary care setting in central Sweden as a part of the Act in Time research project. Prior to a multifaceted implementation strategy, we held 16 individual interviews with managers and appointed facilitators and five focus groups with 26 health care professionals.

Results

Managers, facilitators, and professionals held similar expectations, where their expressed need for support corresponded to three constructs: Readiness for implementation, Implementation climate, and Engaging. Our findings indicate the need for strong leadership engagement to focus on how the healthy lifestyle-promoting practice can be anchored among the professionals. Managers at all levels should communicate the vision and goals, enable facilitators and professionals to improve their competencies, build inter-professional teams, and jointly plan the new practice.

Conclusion

To change to a healthy lifestyle promoting practice professionals request support from their managers, who in turn need support from the middle and top managers. The requested support includes helping to prioritise health promotion and enabling the primary care centres to build competence and take ownership of the implementation.

Trial registration

ClinicalTrials.gov NCT04799860

KEY POINTS

• This study revealed that primary health care managers and health care professionals had mutual expectations of supporting a change into a healthy lifestyle-promoting practice before implementation.

• Strong leadership engagement was perceived as essential across all manager levels, including assistance in prioritising health promotion.

• The support should enable primary health care centres to build competence and have ownership of implementing a healthy lifestyle-promoting practice.

Keywords:

• Qualitative research
• implementation science
• leadership
• primary health care
• health personnel
• healthy lifestyle
• practice guidelines

Acknowledgements

The authors thank the participants for generously sharing their perceptions, thoughts, and time.

Ethical approval

The study was authorised by the Ethical Review Authority, Sweden (references 2020-06956, 2021-00912 and 2021-05825-02) and complies with the Helsinki Declaration of Medical Research Ethics standards.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated and analysed during the current study are not publicly available because they contain information that could compromise the integrity of the participants but are available from the corresponding author at reasonable request.

Additional information

Funding

This work was supported by the Research Committee at Region Örebro County [OLL-969561].