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Primary Care and Public Health Perspectives on Integration at the Local Level: A Multi-State Study
Rebekah Pratt1, Beth Gyllstrom2, Kim Gearin2
1From the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN (RP, KP); Office of Performance Improvement, Minnesota Department of Health, Saint Paul (BG, KG); Department of Family Medicine and Community Health, University of Wisconsin, Madison, WI (DH); School of Public Affairs, University of Colorado-Denver, Denver CO (Formerly with Colorado Association of Local Public Health Officials) (LV); Department of Family Medicine, University of Washington, Seattle, WA (LMB) rjpratt@umn.edu.
Objective:
The Institute of Medicine argues that the integration of primary care (PC) and public health (PH) is of paramount importance. We undertook this qualitative study to better understand how these collaborations function.
Data Sources:
Investigators from PC and PH practice-based research networks in Colorado, Minnesota, Washington, and Wisconsin identified 40 key informants from the PH and PC fields within their respective states.
Study Design:
The key informants participated in standardized, semistructured interviews.
Data Collection:
Coinvestigators from each state conducted telephone interviews. The interviews were recorded, transcribed, and analyzed using NVivo 10.
Principal Findings:
Participants described 2 main types of themes. One, which we have termed "foundational" aspects of partnership, includes leadership, communication, mutual awareness, formal processes, history and values. The other, which we have characterized as "energizing" aspects of partnerships, includes having a shared strategic vision, opportunity, and the shifting culture in PC and PH. While the vast majority of participants described the value of foundational aspects of partnership, those who reported having more active collaborations were more likely to also describe the energizing aspects of partnerships.
Conclusions:
Our findings indicate that interactions between foundational aspects and energizing aspects of partnerships are dynamic. Further exploration of these aspects may help us to understand how best to support the integration of PC and PH.
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