Original Title: Estrategias útiles para la promoción de estilos de vida saludables en atención primaria de salud

Authors' objectives: To determine the opinion of professionals and users concerning the utility of different theoretical and strategical models to promote changes in habits which are damaging to one's health (sedentary lifestyle, diet, smoking and alcohol), as well as those factors that facilitate or hinder their integration within the context of the primary healthcare system.

Authors' results and conclusions: There is a wide range of theoretical models to understand the factors that determine unhealthy conduct and to design actions to combat these. Special consideration is given to models designed to create a belief in health, planned action, social learning, the stages required in order to bring about changes and the integrating models. With regard to strategies, the advice given by health workers is effective against smoking and alcohol abuse. In order to modify diets and increase physical activity levels, the available scientific evidence is sufficient but an approach is recommended whereby emphasis is given to the proven healthy effects involved in the changes. The 5 bywords of the strategy «find out, advise, agree, help and guarantee» are considered to be more feasible and effective than others, such as the motivational interview. Clinical and organisational strategies that might facilitate the integration of these interventions are identified: redesigned agendas giving greater priority to health promotion programmes, cooperation between professionals of different centres, especially the doctor-nurse binomial, selection of target operations, new information and support tools, coordination with resources and organisations in the community, among others. The difficulty of maintaining efficient health promotion under the current conditions of the primary healthcare system is detected The current organisation and resources of primary healthcare centres, which focus almost exclusively on attending to the illness, hinder its sustainable implementation.

Authors' recommendations: Transferring strategies of proven efficiency, such as the 5 bywords, to the clinical practice of the primary healthcare system requires the adaptation of these strategies to the context in which they are to be applied, as well as the reorganisation of centres. The mutual adaptation process between efficient strategies and activity in health centres must be investigated and requires cooperation between researchers, health service professionals and the people responsible for the services. Teaching strategies designed to optimise preventive practice through research, should be seen against a background of a social-technological and intersectorial perspective in which health professionals play a fundamental than complementary role to that of other individual, cultural and social factors. These initiatives require an appropriate theoretical and methodological framework for the design and assessment of complex strategies.

Authors' methods: A review was made of current know-how concerning theoretical models and the effectiveness of strategies that aim to modify the aforementioned habits in adults, within the context of the primary healthcare system. These reviews were studied and discussed interactively in five structured sessions among a group of primary healthcare professionals with special interest in this matter and with experience in health promotion. Their conclusions were compared with those of four discussion groups, two of these being formed by family doctors and the other two by users of primary healthcare services in the Basque Community, exposed to programmes to promote healthy lifestyles.

Project Status: Completed

Year Published: 2008

URL for published report: https://www.euskadi.eus/contenidos/informacion/2008_osteba_publicacion/es_def/adjuntos/D_08_07_estilos_vida.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Basque Office for Health Technology Assessment (OSTEBA)</p>