Opiniones de los profesionales sanitarios sobre la influencia del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS) en atención primaria / Opinions of health professionals on the impact of the preventive activities and health promotion program (PAPPS)

Objetivo: conocer la opinión de los profesionales de Atención Primaria (APS) sobre el impacto y el papel del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS). Diseño: estudio descriptivo cuali-cuantitativo. En una primera fase se empleó la técnica DAFO. En una segunda fase se diseñó un cuestionario de 47 ítems con respuestas mediante una escala ordinal. Ámbito: nivel de Atención Primaria de Salud. Participantes: profesionales de centros de salud PAPPS, responsables del PAPPS y gestores de APS, usando como criterios de segmentación la Comunidad Autónoma, y el tiempo de adscripción o conocimiento del PAPPS. En el estudio cualitativo se hizo una selección por muestreo teorético de 62 participantes; en el estudio cuantitativo, 198 profesionales respondieron a la encuesta. Mediciones principales: la valoración de los resultados se hizo teniendo en cuenta las respuestas a las preguntas formuladas y realizando un análisis cruzado entre fortalezas/amenazas y debilidades/oportunidades. Análisis estadístico descriptivo de las preguntas del cuestionario. Resultados: existe acuerdo en que el PAPPS ha tenido una gran influencia en el desarrollo de la APS, contribuyendo a mejorar la calidad asistencial, pero también en que es fundamental tratar de dinamizar el programa, siendo la principal debilidad la escasa implicación de los profesionales con las recomendaciones preventivas postuladas por falta de motivación y por el desgaste profesional. Conclusiones: Según los participantes el PAPPS ha contribuido de manera significativa al desarrollo de la APS en nuestro país y ha influido sobre la práctica profesional inculcando una cultura de prevención que antes apenas existía (AU)

Objective: to find out the opinion of Primary Health Care (PHC) professionals on the impact of the Preventive Activities and Health Promotion Program (PAPPS). Design: descriptive qualitative-quantitative study. In a first phase the SWOT technique was used. In a second phase a 47 items questionnaire was designed using an ordinal scale. Participants: professionals of PAPPS health centre, PAPPS managers and PHC management, using the Autonomous Community, and the time of ascribing or knowledge of PAPPS as segmentation criteria. In the qualitative study 62 participants were selected by theoretical sampling. In the quantitative study, 198 professionals took part in the survey. Principal measurements: the assessment of the results has taken into account the responses to the questions formulated and by performing a crossed analysis between strengths/threats and weaknesses/opportunities. A descriptive statistical analysis of the questions in the questionnaire. Results: there is agreement in that PAPPS has greatly influenced the development of PHC, contributing to improving the quality of care, but it is also fundamental to try revitalise the programme, as the limited involvement by the professionals in the postulated preventive recommendations is its main weakness, due to lack of motivation and professional burn-out. Conclusions: according to the participants PAPPS has contributed significantly to the development of PHC in our country and has had an influence on professional practice by instilling a prevention culture that hardly existed before (AU)

[Opinions of health professionals on the impact of the Preventive Activities and Health Promotion Program (PAPPS)]. / Opiniones de los profesionales sanitarios sobre la influencia del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS) en atención primaria.

OBJECTIVE: To find out the opinion of Primary Health Care (PHC) professionals on the impact of the Preventive Activities and Health Promotion Program (PAPPS). DESIGN: Descriptive qualitative-quantitative study. In a first phase the SWOT technique was used. In a second phase a 47 item questionnaire was designed using an ordinal scale. PARTICIPANTS: Professionals of PAPPS health centre, PAPPS managers and PHC management, using the Autonomous Community, and the time of ascribing or knowledge of PAPPS as segmentation criteria. In the qualitative study 62 participants were selected by theoretical sampling. In the quantitative study, 198 professionals took part in the survey. PRINCIPAL MEASUREMENTS: The assessment of the results has taken into account the responses to the questions formulated and by performing a crossed analysis between strengths/threats and weaknesses/opportunities. A descriptive statistical analysis of the questions in the questionnaire. RESULTS: There is agreement in that PAPPS has greatly influenced the development of PHC, contributing to improving the quality of care, but it is also fundamental to try revitalise the programme, as the limited involvement by the professionals in the postulated preventive recommendations is its main weakness, due to lack of motivation and professional burn-out.. CONCLUSIONS: According to the participants PAPPS has contributed significantly to the development of PHC in our country and has had an influence on professional practice by instilling a prevention culture that hardly existed before.

Evaluation of preventive and health promotion activities in 166 primary care practices in Spain. The Coordinating Group For Prevention and Health Promotion in Primary Care in Spain.

BACKGROUND: Since January 1989 the Spanish Society of Family and Community Medicine has supported the Program of Prevention and Health Promotion (PAPPS) with the following objectives: to detect possible difficulties in the implementation of recommendations especially among asymptomatic low-risk adults and children in Spain, to disseminate those recommendations, and to encourage research in prevention and health promotion in primary care. OBJECTIVE: We wished to evaluate the implementation of PAPPS in primary care practices. METHODS: A retrospective audit of medical records in practices enrolled in the programme was carried out. From 166 primary care practices widely distributed in Spain 21,631 patients were selected using systematic sampling. RESULTS: Age was positively associated with correct performance in the adult population, while in the paediatric population it was negatively associated. Females had higher probability than males of having blood pressure measurement (OR 1.34, 95% CI 1.24-1.45) and smoking counselling (OR 1.38, 95% CI 1.33-1.43) correctly performed. Practices not using the preventive chart had a lower probability than user practices of correctly performing blood pressure measurement (OR 0.69, 95% CI 0.62-0.76), alcohol counselling (OR 0.66, 95% CI 0.60-0.73) and smoking counselling (OR 0.69, 95% CI 0.63-0.76). Non-teaching practices had a higher probability than teaching centres of correct performance of blood pressure measurement (OR 1.47, 95% CI 1.35 to 1.59), alcohol counselling (OR 1.67, 95% CI 1.54 to 1.79) and smoking counseling (OR 1.39, 95% CI 1.29 to 1.51). CONCLUSIONS: There is an unequal level of performance depending on the procedure and on the target population. A preventive chart might be useful in improving implementation of periodic health maintenance. Teaching centres with training physicians need to put more emphasis on prevention and health promotion activities.

[Evaluation of the program for preventive measures and health promotion for adults in a health service area]. / Evaluación del programa de actividades preventivas y promoción de la salud del adulto en una área sanitaria.

OBJECTIVE: To evaluate the Preventive Measures and Health Promotion Programme (PMHPP), in order to find its spread of influence and to identify consequent problems, with the aim of putting in place measures to improve effectiveness. DESIGN: Observational, crossover and retrospective study, using random distribution. SETTING: Primary Care teams (PCT) of Health Area 11, Madrid. PARTICIPANTS: Ten clinical records from each general practitioner/nurse case-load of the 24 PCT in the Area: 1470 clinical records in all. INTERVENTIONS: Clinical auditing carried out in October 1992. MEASUREMENTS AND MAIN RESULTS: Prevalences obtained were: 19.3 +/- 1.03 for AHT, 34.4 +/- 1.24 for tobacco dependency, 17 +/- 0.84 for Hypercholesterolaemia and 20.7 +/- 1.02 for obesity-overweight. All the percentages were higher for patients who attended for the last time in 1992 (p < 0.001), except those concerning breast and cervical cancer screening. CONCLUSIONS: 1. The prevalences obtained from the FR.CV. are close to those theoretically expected. 2. Measures aimed at A.T., tobacco and alcohol were correctly carried out for more than 75% of the patients and were applied to over 50% of the relevant population. 3. Anti-tetanus and anti-rubella vaccinations and breast cancer screening were correctly performed only in just over 25% of cases. 4. Correct compliance with the majority of the measures was higher among users who attended for the last time after the Programme's introduction.