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Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study.

ABSTRACT: Background: Considering the lack of accreditation models for health education and promotion(HEP) activities in the Iranian primary health care (PHC) system we conducted the present study to develop a national accreditation model for HEP actions in the Iranian PHC system. Methods: After a comprehensive review on the accreditation models in PHC field, especially those concentrated on the HEP programs, an initial HEP accreditation model was developed.Then, applying the Delphi technique, 18 experts in the Iranian PHC system with field experience in HEP programs were invited to assess the initial model. In the two-round Delphi study,aggregation was provided on the opinions and the standards and indicators were finalized.Conventional content analysis was applied to make sense of the data collected in the study. Results: The developed HEP accreditation model encompassed 62 indicators and five standards.The standards were as follow: "resources for HEP programs", "educational needs assessment of the target groups", "methods of providing a community with education", "management of health volunteers' actions" and "evaluation of HEP programs". Conclusion: The standards and indicators found in the present study may serve as an educational rationale for health educators while designing high-quality health education/promotion programs. This model may be helpful for health policy-makers and stakeholders while planning to assess the continuous quality improvement of HEP services delivered in the PHC systems.

SUBMITTER: Gharibi F

PROVIDER: S-EPMC5935820 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study.

Gharibi Farid F Tabrizi Jafar Sadegh JS

Health promotion perspectives 20180418 2

<b>Background:</b> Considering the lack of accreditation models for health education and promotion(HEP) activities in the Iranian primary health care (PHC) system we conducted the present study to develop a national accreditation model for HEP actions in the Iranian PHC system. <b>Methods:</b> After a comprehensive review on the accreditation models in PHC field, especially those concentrated on the HEP programs, an initial HEP accreditation model was developed.Then, applying the Delphi techniqu ...[more]

PMID: 29744312

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Project description:BACKGROUND:Implementation of evidence-based programs (EBPs) for disease self-management and prevention is a policy priority. It is challenging to implement EBPs offered in community settings and to integrate them with healthcare. We sought to understand, categorize, and richly describe key challenges and opportunities related to integrating EBPs into routine primary care practice in the United States. METHODS:As part of a parent, participatory action research project, we conducted a mixed methods evaluation guided by the PRECEDE implementation planning model in an 11-county region of Southeast Minnesota. Our community-partnered research team interviewed and surveyed 15 and 190 primary care clinicians and 15 and 88 non-clinician stakeholders, respectively. We coded interviews according to pre-defined PRECEDE factors and by participant type and searched for emerging themes. We then categorized survey items-before looking at participant responses-according to their ability to generate further evidence supporting the PRECEDE factors and emerging themes. We statistically summarized data within and across responder groups. When consistent, we merged these with qualitative insight. RESULTS:The themes we found, "Two Systems, Two Worlds," "Not My Job," and "Seeing is Believing," highlighted the disparate nature of prescribed activities that different stakeholders do to contribute to health. For instance, primary care clinicians felt pressured to focus on activities of diagnosis and treatment and did not imagine ways in which EBPs could contribute to either. Quantitative analyses supported aspects of all three themes, highlighting clinicians' limited trust in community-placed activities, and the need for tailored education and system and policy-level changes to support their integration with primary care. CONCLUSIONS:Primary care and community-based programs exist in disconnected worlds. Without urgent and intentional efforts to bridge well-care and sick-care, interventions that support people's efforts to be and stay well in their communities will remain outside of-if not at odds with-healthcare.

Project description:BackgroundIn this study, we sought to assess healthcare professionals' acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceived facilitators and barriers to the implementation of SDM in clinical settings in Iran.MethodsWe conducted an observational quantitative study that involved measurements before, during, and immediately after the educational intervention at stake. We invited healthcare professionals affiliated with Tabriz University of Medical Sciences, East Azerbaijan, Iran, to attend a half-day workshop on SDM in December 2016. Decisions about prenatal screening and knee replacement surgery was used as clinical vignettes. We provided a patient decision aid on prenatal screening that complied with the International Patient Decision Aids Standards and used illustrate videos. Participants completed a sociodemographic questionnaire and a questionnaire to assess their familiarity with SDM, a questionnaire based on theoretical domains framework to assess their intention to implement SDM, a questionnaire about their perceived facilitators and barriers of implementing SDM in their clinical practice, continuous professional development reaction questionnaire, and workshop evaluation. Quantitative data was analyzed descriptively and with multiple linear regression.ResultsAmong the 60 healthcare professionals invited, 41 participated (68%). Twenty-three were female (57%), 18 were specialized in family and emergency medicine, or community and preventive medicine (43%), nine were surgeons (22%), and 14 (35%) were other types of specialists. Participants' mean age was 37.51?±?8.64?years with 8.09?±?7.8?years of clinical experience. Prior to the workshop, their familiarity with SDM was 3.10?±?2.82 out of 9. After the workshop, their belief that practicing SDM would be beneficial and useful (beliefs about consequences) (beta?=?0.67, 95% CI 0.27, 1.06) and beliefs about capability of using SDM (beta?=?0.32, 95% CI -0.08, 0.72) had the strongest influence on their intention of practicing SDM. Participants perceived the main facilitator and barrier to perform SDM were training and high patient load, respectively.ConclusionsParticipants thought the workshop was a good way to learn SDM and that they would be able to use what they had learned in their clinical practice. Future studies need to study the level of intention of participants in longer term and evaluate the impact of cultural differences on practicing SDM and its implementation in both western and non-western countries.

Dataset Information

Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study.

Publications

Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study.

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