Table 3.
Summary of proposals to enhance integration of healthy lifestyle promotion into PHC
| 1.- Increase availability of resources |
| • Increase the interaction time between patients and professionals in order to open their work agendas to health promotion: |
| - review care protocols for healthy people |
| - decrease checks for people with chronic diseases, promoting patient self-control and autonomy |
| - expressly prioritise health promotion activities and the reminding and recording of such activities |
| - effective administrative support to free practitioners from administrative and bureaucratic tasks |
| - communication, task redistribution, coordination and mutual support between physicians and nurses. |
| • Health policies defining the role of PHC in health promotion. |
| • Agreements between funding bodies and service providers specifically stating health promotion objectives, resources and indicators for evaluation. |
| • Participation of professionals in planning and quality evaluation of PHC services: |
| - promote communication within the health-care system |
| - establish common health promotion objectives for all professionals in the health-care organisation |
| - negotiate evaluation indicators shared by all groups. |
| • Actions at an inter-institutional level: town councils, schools, health-care centres, citizens' organisations, etc. |
| - designate a health promotion coordinator post at district or town level |
| - integrate initiatives and resources of the different sectors involved. |
| 2.- Design of intervention programs |
| • Review their rationale based on scientific evidence of their effectiveness. |
| • Promote research into health promotion in PHC. |
| • Prioritise programs that are more flexible and adaptable to context. |
| • Participation of clinicians and researchers in the design and evaluation of new interventions. |
| • Use new support and reminder tools that do not interfere with the clinical practice of professionals. |
| • Take advantage of the new technologies for citizen information and education. |
| 3.- Program dissemination |
| • Fight against resistance to change using outcome research. |
| • Set up a network of centres particularly interested in innovation for addressing multiple risk factors in PHC. |
| • Experience-based training and action-oriented skills. |