Barriers to the adoption of the BCP-VAMOS 3.0 in Primary Health Care: a quality study

Authors

DOI:

https://doi.org/10.47197/retos.v50.99032

Keywords:

adopción

Abstract

The study aimed to evaluate the barriers to the adoption of the Active Life Improving Health Behavior Change Program (BCP-VAMOS), version 3.0, in Primary Health Care (PHC) in the state of Santa Catarina. A qualitative research was carried out with 33 health professionals (HP) who did not adopt the BCP-VAMOS 3.0. PS answered 25 questions electronically (Google Forms). To organize and interpret the results, the technique of descriptive content analysis was used in the QSR Nvivo® 12.0 software. Data were categorized based on the CFIR (Consolidated Framework for Implementation Research) which describes five domains: intervention characteristics, outer setting, Inner setting, individual characteristics and implementation process. The results showed barriers for not adopting the BCP-VAMOS in four domains of the CFIR: outer setting (low interest of the population); inner setting (compatible time/time, physical structure, professional turnover, work overload and work logistics); individual characteristics (insecurity, belief of not having a profile to implement the program; belief that the program was inadequate for the health sector); and, process (lack of support from the management/team, similar actions at healh centers and difficulty in publicizing). It was concluded that the barriers perceived by the PS not to adopt the BCP-VAMOS 3.0 were related to the organization's structure, work planning, definition of roles and performance of the team.

Keywords: Adoption. Primary Health Care. Barriers. Implementation Science. Health Promotion.

References

Anjos, V. Ávila A. dos, Tavares, G. H., Ferreira, J. S., & Silva, J. V. P. da. (2021). Políticas de promoción de la salud pública y orientación profesional en AAL en Campo Grande/MS, Brasil (Public health promotion policies and professional guidance in the Outdoor Gyms in Campo Grande/MS, Brazil). Retos, 41, 112–122. https://doi.org/10.47197/retos.v0i41.83012

Arigo, D., Pagoto, S., Carter-Harris, L., Lillie, S. E., & Nebeker, C. (2018). Using social media for health research: Methodological and ethical considerations for recruitment and intervention delivery. Digital health, 4. https://doi.org/10.1177/2055207618771757.

Bardin, L. (2011). Análise de conteúdo. São Paulo: Edições 70.

Bauer, M. S., & Kirchner, J. (2020). Implementation science: What is it and why should I care? Psychiatry research, 283, 112376. https://doi.org/10.1016/j.psychres.2019.04.025.

Bazemore, A., Petterson, S., Peterson, L. E., Bruno, R., Chung, Y., & Phillips, R. L., Jr (2018). Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations. Annals of family medicine, 16(6), 492–497. https://doi.org/10.1370/afm.2308.

Becker, LA, Loch, MR, & Rodrigo Siqueira, R. (2017). Barreiras percebidas por diretores de saúde para tomada de decisão baseada em evidências [Barreiras percebidas por diretores de saúde para tomada de decisão baseada em evidências Revista panamericana de salud publica = Revista Panamericana de Saúde Pública, 41, e147. https://doi.org/10.26633/RPSP.2017.147.

Beidas, R. S., Edmunds, J. M., Marcus, S. C., & Kendall, P. C. (2012). Training and consultation to promote implementation of an empirically supported treatment: a randomized trial. Psychiatric services (Washington, D.C.), 63(7), 660–665. https://doi.org/10.1176/appi.ps.201100401.

Belizan, M., Chaparro, R. M., Santero, M., Elorriaga, N., Kartschmit, N., Rubinstein, A. L., & Irazola, V. E. (2019). Barriers and Facilitators for the Implementation and Evaluation of Community-Based Interventions to Promote Physical Activity and Healthy Diet: A Mixed Methods Study in Argentina. International journal of environmental research and public health, 16(2), 213. https://doi.org/10.3390/ijerph16020213

Benedetti, T. R. B., Schwingel, A, Gomez, L. S., & Wojtek C. (2012). Programa “VAMOS” (Vida Ativa Melhorando a Saúde): da concepção aos primeiros resultados. Revista Brasileira de Cineantropometria e Desempenho Humano, 14(6), 723-737. https://doi.org/10.5007/1980-0037.2012v14n6p723.

Benedetti, T. R. B., Manta, S., Gomez, L., & Rech, C. (2017). Logical model of a behavior change program for community intervention – Active Life Improving Health – VAMOS. Revista Brasileira De Atividade Física & Saúde, 22(3), 309–313. https://doi.org/10.12820/rbafs.v.22n3p309-313

Benedetti, T. R. B. Grontowski, C. R., & Konrad, L. M. (2019). VAMOS: vida ativa melhorando a saúde. Programa Vida Ativa Melhorando a Saúde. 2 ed. Florianópolis: UFSC.

Benedetti, T., Rech, C. R., Konrad, L. M., Almeida, F. A., Brito, F. A., Chodzko-Zajko, W., & Schwingel, A. (2020). Re-thinking Physical Activity Programs for Older Brazilians and the Role of Public Health Centers: A Randomized Controlled Trial Using the RE-AIM Model. Frontiers in public health, 8, 48. https://doi.org/10.3389/fpubh.2020.00048.

Borges, R. T., Tomicki, C., Almeida, F. A., Schwingel, A., Chodzko-Zajko W., & Benendetti, T. R. B. (2019). Alcance do programa “VAMOS” na atenção básica - barreiras organizacionais e facilitadores. Revista Brasileira de Geriatria & Gerontologia, 22(3). DOI: 10.1590/1981-22562019022.180225

Brasil (2008). Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Manual de estrutura física das unidades básicas de saúde: saúde da família. Ministério da Saúde, Brasília, DF.

Brasil (2014). Guia alimentar para a população brasileira. 2ª ed. Brasília, Distrito Federal: Ministério da Saúde. [citado 2021 jan 20]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf

Brasil (2017). Portaria nº 2.436, de 21 de setembro de 2017. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes para a organização da Atenção Básica, no âmbito do Sistema Único de Saúde (SUS). Ministério da Saúde, Brasília, DF.

Brasil (2019). Departamento de Dados do Sistema Único de Saúde – DATASUS, 2019. Disponível em < http://tabnet.datasus.gov.br>. Acesso 10 janeiro de 2019.

Brasil (2021a). Guia de atividade física para a população brasileira. Brasília, Distrito Federal: Ministério da Saúde. [citado 2021 jul 2]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/guia_atividade_fisica_populacao_brasileira.pdf

Brasil (2021). Ministério Da Saúde. Secretaria De Atenção Primária À Saúde. Departamento De Promoção Da Saúde. Recomendações para o Desenvolvimento de Práticas Exitosas de Atividade Física na Atenção Primária à Saúde do Sistema Único de Saúde/ Ministério da Saúde, Secretaria de Atenção Primária à Saúde. Brasília: Ministério da Saúde.

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., Carty, C., Chaput, J. P., Chastin, S., Chou, R., Dempsey, P. C., DiPietro, L., Ekelund, U., Firth, J., Friedenreich, C. M., Garcia, L., Gichu, M., Jago, R., Katzmarzyk, P. T., Lambert, E., … Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine, 54(24), 1451–1462. https://doi.org/10.1136/bjsports-2020-102955.

Carroll, J. K., Yancey, A. K., Spring, B., Figueroa-Moseley, C., Mohr, D. C., Mustian, K. M., Sprod, L. K., Purnell, J. Q., & Fiscella, K. (2011). What are successful recruitment and retention strategies for underserved populations? Examining physical activity interventions in primary care and community settings. Translational Behavioral Medicine, 1(2), 234–251. https://doi.org/10.1007/s13142-011-0034-2

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science: IS, 4(50). https://doi.org/10.1186/1748-5908-4-50.

Edmunds, J. M., Beidas, R. S., & Kendall, P. C. (2013). Dissemination and Implementation of Evidence-Based Practices: Training and Consultation as Implementation Strategies. Clinical psychology: a publication of the Division of Clinical Psychology of the American Psychological Association, 20(2), 152–165. https://doi.org/10.1111/cpsp.12031.

Escoffery, C., Lebow-Skelley, E., Haardoerfer, R., Boing, E., Udelson, H., Wood, R., Hartman, M., Fernandez, M. E., & Mullen, P. D. (2018). A systematic review of adaptations of evidence-based public health interventions globally. Implementation Science: IS, 13(1), 125. https://doi.org/10.1186/s13012-018-0815-9.

Florindo, A. A., Nakamura, P. M., Farias Júnior, J. C. de, Siqueira, F. V., Reis, R. S., Cruz, D. K. A., & Hallal, P. C. (2016). Promoção da atividade física e da alimentação saudável e a saúde da família em municípios com academia da saúde. Revista Brasileira De Educação Física E Esporte, 30(4), 913-924. https://doi.org/10.1590/1807-55092016000400913.

Galaviz, K. I., Harden, S. M., Smith, E., Blackman, K. C., Berrey, L. M., Mama, S. K., Almeida, F. A., Lee, R. E., & Estabrooks, P. A. (2014). Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity. The international journal of behavioral nutrition and physical activity, 11, 77. https://doi.org/10.1186/1479-5868-11-77.

Gerage, A. M., Benedetti, T., Ritti-Dias, R. M., Dos Santos, A., de Souza, B., & Almeida, F. A. (2017). Effectiveness of a Behavior Change Program on Physical Activity and Eating Habits in Patients With Hypertension: A Randomized Controlled Trial. Journal of physical activity & health, 14(12), 943–952. https://doi.org/10.1123/jpah.2016-0268.

Giehl, M. W. C., Schneider, I., Corseuil, H. & d'Orsi, E. (2012). Atividade física e percepção do ambiente em idosos: estudo populacional em Florianópolis. Revista de Saúde Pública, 46(3), 516-25. https://doi.org/10.1590/S0034-89102012005000026.

Glasgow, R. E., Harden, S. M., Gaglio, B., Rabin, B., Smith, M. L., Porter, G. C., Ory, M. G., & Estabrooks, P. A. (2019). RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review. Frontiers in public health, 7, (64). https://doi.org/10.3389/fpubh.2019.00064

Gustavsson, C., Nordqvist, M., Bröms, K., Jerdén, L., Kallings, L. V., & Wallin, L. (2018). What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management. BMC health services research, 18(1), 196. https://doi.org/10.1186/s12913-018-3021-1.

Holtrop, J. S., Estabrooks, P. A., Gaglio, B., Harden, S. M., Kessler, R. S., King, D. K., Kwan, B. M., Ory, M. G., Rabin, B. A., Shelton, R. C., & Glasgow, R. E. (2021). Understanding and applying the RE-AIM framework: Clarifications and resources. Journal of clinical and translational science, 5(1), e126. https://doi.org/10.1017/cts.2021.789

IJsbrandy, C., van Harten, W. H., Gerritsen, W. R., Hermens, R., & Ottevanger, P. B. (2020). Healthcare professionals' perspectives of barriers and facilitators in implementing physical activity programmes delivered to cancer survivors in a shared-care model: a qualitative study. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 28(7), 3429–3440. https://doi.org/10.1007/s00520-019-05108-1.

Keyworth, C., Epton, T., Goldthorpe, J., Calam, R., & Armitage, C. J. (2019). 'It's difficult, I think it's complicated': Health care professionals' barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations. British journal of health psychology, 24(3), 571–592. https://doi.org/10.1111/bjhp.12368.

Konrad, L., Tomicki, C., Silva, M., Almeida, F., & Benedetti, T. (2017). Avaliação de programas de mudança de comportamento usando a ferramenta RE-AIM: um estudo de revisão sistemática. Revista Brasileira De Atividade Física & Saúde, 22(5), 439–449. https://doi.org/10.12820/rbafs.v.22n5p439-449.

Konrad, L. M., Tomicki, C., Ribeiro, C. G., Bezerra, J. B., Maciel, E. C., Rech, C. R., Pitanga, F. J. G., & Benedetti, T. R. B. (2019). Length of stay in a behavior change program in Primary Health Care: “VAMOS” Program. Revista Brasileira De Atividade Física & Saúde, 24, 1–7. https://doi.org/10.12820/rbafs.24e0090.

Konrad, L. M., Ribeiro, C. G., Tomicki, C., & Benedetti, T. R. B. (2020). Validação de tecnologia educacional para implementar um programa comunitário na saúde pública. Revista Brasileira De Atividade Física & Saúde, 25, 1–6. https://doi.org/10.12820/rbafs.25e0155.

Konrad, L. M., Ribeiro, C. G., Maciel, E. C., Tomicki, C., Brito, F. A., Almeida, F. A., & Benedetti, T. R. B. (2022). Evaluating the implementation of the active life improving health behavior change program “BCP-VAMOS” in primary health care: Protocol of a pragmatic randomized controlled trial using the RE-AIM and CFIR frameworks. Frontiers in Public Health, 10, [726021]. https://doi.org/10.3389/fpubh.2022.726021.

Lau, R., Stevenson, F., Ong, B. N., Dziedzic, K., Treweek, S., Eldridge, S., Everitt, H., Kennedy, A., Qureshi, N., Rogers, A., Peacock, R., & Murray, E. (2015). Achieving change in primary care--effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews. BMJ open, 5(12), e009993. https://doi.org/10.1136/bmjopen-2015-009993.

Long, H., Huang, W., Zheng, P., Li, J., Tao, S., Tang, S., & Abdullah, A. S. (2018). Barriers and Facilitators of Engaging Community Health Workers in Non-Communicable Disease (NCD) Prevention and Control in China: A Systematic Review (2006⁻2016). International journal of environmental research and public health, 15(11), 2378. https://doi.org/10.3390/ijerph15112378.

Manta, S. W., Sandreschi, P. F., Tomicki, C., Konrad, L. M., Quadros, E. N., Ribeiro, C. G., Bezerra, J. B., Souza, P. V., Maciel, E. C., Cruz, D. K. A., & Benedetti, T. R. B. (2020). Monitoramento do programa academia da saúde de 2015 a 2017. Revista Andaluza de Medicina del Deporte, 13(1).

Medeiros, C., Junqueira, A., Schwingel, G., Carreno, I., Jungles, L., & Saldanha, O. (2010). A rotatividade de enfermeiros e médicos: um impasse na implementação da Estratégia de Saúde da Família. Ciencia & Saúde Coletiva, 15. https://doi.org/10.1590/S1413-81232010000700064.

Meurer, S. T., Lopes, A., Almeida, F. A., Mendonça, R. D., & Benedetti, T. (2019). Effectiveness of the VAMOS Strategy for Increasing Physical Activity and Healthy Dietary Habits: A Randomized Controlled Community Trial. Health education & behavior : the official publication of the Society for Public Health Education, 46(3), 406–416. https://doi.org/10.1177/1090198118820095.

Meurer, S. T., Borges, L. J., Gerage, A. M., Lopes, A. C. S., Benedetti, T. R. B (2020). Promotion of physical activities and healthy eating habits in Primary Care: maintenance of benefits. Revista de Nutrição, 33. https://doi.org/10.1590/1678-9865202033e190120.

Nadeem, E., Gleacher, A., & Beidas, R. S. (2013). Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box. Administration and policy in mental health, 40(6), 439–450. https://doi.org/10.1007/s10488-013-0502-8.

Ndejjo, R., Wanyenze, R. K., Nuwaha, F., Bastiaens, H., & Musinguzi, G. (2020). Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research. Implementation Science: IS, 15(1), 106. https://doi.org/10.1186/s13012-020-01065-0.

O'Cathain, A., Croot, L., Duncan, E., Rousseau, N., Sworn, K., Turner, K. M., Yardley, L., & Hoddinott, P. (2019). Guidance on how to develop complex interventions to improve health and healthcare. BMJ open, 9(8), e029954. https://doi.org/10.1136/bmjopen-2019-029954.

Paiva Neto, F. T., Mazo, G. Z., Sandreschi, P. F., Petreça, D. R., & Rech, C. R. (2019). Barriers to implementation of "Academia da saúde program" in Santa Catarina. Journal of Physical Education, 30(1). https://doi.org/10.4025/jphyseduc.v30i13046

Pialarissi, R. (2017). Precarização do Trabalho. Revista de Administração em Saúde, 17(66).

Ramos, L. R., Malta, D. C., Gomes, G. A., Bracco, M. M., Florindo, A. A., Mielke, G. I., Parra, D. C., Lobelo, F., Simoes, E. J., & Hallal, P. C. (2014). Prevalence of health promotion programs in primary health care units in Brazil. Revista de saúde pública, 48(5), 837–844. https://doi.org/10.1590/s0034-8910.2014048005249.

Ribeiro, C. G., Konrad, L. M., Tomicki, C., Almeida, F. A., Brito, F. A. & Benedetti, T. R. B.(2021). Evaluation of the didatic material of the Active Life Improving Health? Program (VAMOS), version 3.0. e-Revista LOGO, 10, 72-92, 2021. https://doi.org/10.26771/e-Revista.LOGO.

Robbins, S. P. (2005). Comportamento organizacional. 11ª ed. São Paulo: Prentice Hall.

Valera, M., Pons-Vigués, M., Martínez-Andrés, M., Moreno-Peral, P., Berenguera, A., & Fernández, A. (2014). Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through meta-ethnography. PloS one, 9(2), e89554. https://doi.org/10.1371/journal.pone.0089554.

Sandreschi, P. F., Petreça, D. R., Mazo, G. Z., & Fank, F. (2019). Barreiras para o desenvolvimento de atividades físicas para idosos: a visão dos secretários municipais de saúde de Santa Catarina. Estudos Interdisciplinares Sobre O Envelhecimento, 24. https://doi.org/10.22456/2316-2171.97664

Soares Neto, J. J., Machado, M. H., & Alves, C. B. (2016). The Mais Médicos (More Doctors) Program, the infrastructure of primary health units and the municipal human development index. Ciência & Saúde Coletiva, 21 (9). https://doi.org/10.1590/1413-81232015219.16432016.

Sopcak, N., Aguilar, C., O'Brien, M. A., Nykiforuk, C., Aubrey-Bassler, K., Cullen, R., Grunfeld, E., & Manca, D. P. (2016). Implementation of the BETTER 2 program: a qualitative study exploring barriers and facilitators of a novel way to improve chronic disease prevention and screening in primary care. Implementation Science: IS, 11(1), 158. https://doi.org/10.1186/s13012-016-0525-0.

Tomicki, C., Rech, C. R., Gerage, A. M., Corrêa, E., N., Konrad, L. M., & Benedetti, T. R. B. (2021). Adoption of an intervention to promote physical activity and healthy eating in brazilian health care settings. Research, Society and Development, 10(13)

Tonelli, B., Leal, A., Tonelli, W., Veloso, D., Gonçalves, D., & Quadros, S. T. (2018). Rotatividade de profissionais da Estratégia Saúde da Família no município de Montes Claros, Minas Gerais, Brasil. Revista da Faculdade de Odontologia – Ufp, 23(2) 180-185. https://doi.org/10.5335/rfo.v23i2.8314.

Tong, A., Sainsbury, P., & Craig, J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups, International Journal for Quality in Health Care,19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042.Parte superior do formulário

Tonosaki, L. M. D., Rech, C. R., Mazo, G. Z., Antunes, G. A., & Benedetti, T. R. B. (2018). Barreiras e facilitadores para a participação em um programa de mudança de comportamento: análise de grupos focais. Revista Brasileira de Ciências do Esporte, 40(2), 138-145, 2018. https://doi.org/10.1016/j.rbce.2018.01.012.

World Health Organization (2013). Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva, Switzerland.

World Health Organization (2020). Noncommunicable diseases progress monitor 2020. [citado 2021 Jan 17]. Disponível em: https://www.who.int/publications/i/item/ncd-progress-monitor-2020. Acesso em

Published

2023-09-15

How to Cite

Maciel, E., Konrad , L. M. ., Ribeiro Grontowski , C. ., & Bertoldo Benedetti, T. R. . (2023). Barriers to the adoption of the BCP-VAMOS 3.0 in Primary Health Care: a quality study. Retos, 50, 1323–1332. https://doi.org/10.47197/retos.v50.99032

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