Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed...

Area of Science:

• Public Health
• Primary Care
• Health Services Research

Background:

• The Building on Existing Tools to Improve Chronic Disease Prevention and Screening (BETTER) trial demonstrated the effectiveness of a prevention practitioner role in improving chronic disease prevention and screening (CDPS).
• The BETTER 2 program builds upon the success of the original BETTER trial, aiming for broader implementation and evaluation.
• Key goals include enhancing clinical outcomes, reducing chronic disease burden, and improving healthcare system sustainability.

Purpose of the Study:

• To describe the planned implementation and evaluation of the BETTER 2 program.
• To expand the BETTER intervention into diverse Canadian communities.
• To assess the effectiveness and sustainability of integrated CDPS in primary care.

Main Methods:

• The BETTER 2 program involves prevention practitioners delivering personalized, multi-condition, integrated, and longitudinal 'prevention prescriptions' to at-risk adults aged 40-65.
• Implementation spans multiple Canadian provinces and territories.
• Evaluation will utilize the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework with qualitative and quantitative methods, including a composite index to assess intervention effectiveness.

Main Results:

• The study is designed to evaluate the implementation and effectiveness of the BETTER 2 program.
• A composite index will quantify the impact of the prevention practitioner intervention on CDPS actions.
• Data will be collected on process measures, referral/treatment, and outcomes related to cardiovascular disease, diabetes, cancer, and lifestyle factors.

Conclusions:

• BETTER 2 represents a collaborative, practice-based approach focused on integrating existing successful models.
• The program evaluation will identify factors influencing the implementation and sustainability of effective CDPS in primary care settings.
• Findings aim to inform adaptations for sustainable, non-research implementation of improved CDPS.