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WP Title: Feasibility studies of selective prevention actions
WP Leader: University of Crete
Period: February 2017 – February 2018
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Objective
To test the feasibility of implementing the tailored selective prevention programs (designed in WP7) in five EU Member States with regards to their acceptance and participation rate.
Deliverables
1. Protocol for implementing feasibility studies
2. Database of feasibility studies in five EU Member States completed
3. Final report on feasibility studies
Description of work
Design and protocol for the feasibility studies
A feasibility study will be carried out in primary care practices from five European Member States (Sweden, Denmark, the Netherlands, Czech Republic and Greece). The implementation of the selective prevention program for the feasibility study will be tailored to the context in each country, which is the result of WP7. The implementation will be tested in a feasibility study in five EU Member States for which a study protocol will be developed and approved by the SPIMEU steering committee before the start of the feasibility study.
Participants
For establishing the feasibility of tailored selective prevention programs, in each Member State a maximum of ten primary care practices will be invited to participate. The selection of practices will be based on criteria to ensure that different practice settings are represented (public/private, solo/group, different urbanisation levels). Professionals (i.e. primary care physicians and nurses) working in each setting/practice will be invited to participate, and in each practice a random sample of 20 persons attending each practice will be recruited out of the group of persons attending who are deemed to be eligible for the selective prevention program, on the basis of the information available in their medical record.
Training
A one-day training workshop will be organised in each participating EU Member State to inform the participating primary care professionals about the selective prevention program (tailored to the national context) and the feasibility study. The training will include the implementation of the selective prevention program in the practice, and the collection of data to establish the feasibility. It will also emphasize aspects such as recruitment criteria for eligibility (i.e. selection for prevention on the basis of previous medical history, other risk factors recorded in the records), as well as accuracy in data collection.
Outcome measures and measurements
The feasibility of the implementation of the tailored selective prevention programme includes the acceptability by the professionals and the participants, and the actual participation and compliance with the program. The feasibility of the program will be established by questionnaires, to be filled in by the participating professionals (primary care physicians and nurses) and by the invited participants.
Questions for professionals regard the feasibility of implementing the selective prevention program in their practice, the time estimated and allocated to implement the program, the disciplines involved, and whether they consider the program as an important element of their services. An additional item will focus on eliciting preferences on integrating selective prevention actions in the usual standard of care provided. To ensure sustainability, the aforementioned feasibility questions will address both short- and long-term implementation.
Questions for participants will include the acceptability of being invited for establishing a risk profile, as well as experiences with its content. The actual participation rate (number of respondents in different phases of the selective prevention program) will be measured by a careful administration in each practice. The compliance with the program will be established by a questionnaire to all invited participants to measure to what extent participants completed the selective prevention program and to what extent they consider the program as useful, as relevant for their health status, whether they intend to undertake risk reducing actions and what barriers they experience in understanding such actions. The Theory of Planned Behaviour as it has been utilised in previous studies will guide towards the development of the questionnaire.
Analyses
The feasibility of the tailored selective prevention program will be established first for each Member State separately. In addition, an overall analysis will be carried out to assess the feasibility of the program in general, and by taking the tailoring of the programs into account. The results will be correlated to the previous questionnaires addressing the acceptability of preventive actions (see WP5 and WP6). Contextual factors and individual system characteristics will be the basis of analysing differential responses of country-level acceptability versus overall acceptability to provide data to tailor future actions.
Recommendations
On the basis of the results of the feasibility studies in the five EU Member States, recommendations will be formulated regarding the acceptability and efficiency of selective prevention programs in different health care system setting. These recommendations will be used as an input for creating a toolbox for implementing selective prevention programs (see WP2).
Organisation of tasks
University of Crete will lead this Work Package and will coordinate the feasibility studies in each of the five EU Member States. Each SPIMEU participant will support the implementation of the feasibility study in his own country by obtaining medical ethical approval (if necessary according to national legislation), recruiting practices for participation, support the translation of questionnaires, organise the training workshop and by monitoring the implementation. University of Crete will conduct the analyses on the feasibility.