Integrating prevention into primary care organizations: a case study in France

Although primary care providers have a major role to play in combating risk factors, preventive practices can still be improved. The development of coordinated practice is considered as an opportunity to integrate prevention into primary care. What are the conditions, obstacles and facilitators involved in such a process?

To explore and describe the conditions under which prevention is integrated into 'communautés professionnelles territoriales de santé' (CPTS = territorial professional health communities) in France, a new type of primary care organization being generalized in France.

A case study was conducted in two regions of France. We conducted interviews with: (i) healthcare professionals and coordinators, and (ii) local healthcare authorities and territorial officers for the CPTS. Data were collected through individual and semi-structured group interviews, observations and a documentary analysis. They were then coded by two investigators according to two coding trees depending on the population involved. A thematic analysis was then carried out.

This case study was composed of 18 interviews, two observations and three documents. They showed that healthcare professionals and healthcare authorities do not share the same vision, issues and expectations regarding prevention. For the former, prevention should be integrated into care as in preventive clinical practices, while the latter are more focused on the healthcare system with a vision based on prevention programs.

This study identified the obstacles and facilitators to integrating prevention into coordinated practices in primary care.