2015
FACULTY OF MEDICINE AND HEALTH SCIENCES
Linköping University Medical Dissertations No. 1464, 2015 Department of Medical and Health Sciences
Linköping University SE-581 83 Linköping, Sweden
www.liu.se
Implementation of
coordinated healthy
lifestyle promotion
in primary care
Process and outcomes
Linköping University Medical Dissertations No. 1464
Kristin Thomas
Implement
ation of coor
dinat
ed healthy lif
estyle pr
omotion in primary car
e
This thesis considers the implementation of practice change in a real-world setting. Coordinated care and multi-professional teamwork have emerged as ways to improve healthy lifestyle promotion routines in primary care. In 2008, the Western division in Östergötland County Council commissioned primary care to implement lifestyle teams; a coordinated care initiative to improve and standardize routines regarding lifestyle promotion.
The implementation of three lifestyle teams at three primary care centres was studied over a period of two years. The implementation process was characterized by complexity including multiple agents and components. Various groups of staff and patients took part in the implementation in different ways. Differences in conditions for change, e.g. resources and commitment, between agents challenged the incorporation of the teams and routines at the centres. Patients also took part in the implementation of healthy lifestyle promotion highlighting patients as agents in the implementation process. Team members continuously redefined their work to accommodate contextual factors, features of the initiative and patient needs. The lifestyle team initiative offered an infrastructure for practice routines. However, it had limited impact on healthy lifestyle promotion practice among health care staff.
Kristin Thomas is a researcher at the
Department of Medical and Health Sciences, Linköping University. Her research interests include Health psychology, behaviour change and implementation in health care. This is her doctoral thesis.
