THE HEALTH PROMOTION PROGRAM FOR INDIVIDUALS AT RISK FOR CARDIOVASCULAR DISEASES AND DIABETES IMPLEMENTATION IN MUNICIPALITY: THE STAKEHOLDERS’ PERSPECTIVE

Ž. Šedytė, G. Petronytė
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Abstract

This article analysis the health promotion program for individuals at risk for cardiovascular diseases and diabetes implemented jointly by primary health care institutions and the public health bureau in the municipality of Panevėžio city. A qualitative study using a semi-structured interview method was performed in January – February 2018, involving ten representatives of primary health care institutions and the public health bureau which have concluded the cooperation agreement. In the context of the health promotion program implementation, the main collaboration forms between primary health care institutions and the public health bureau remain sending official documents by email and meetings in primary health care institutions. The key prerequisites for the development of closer collaboration are an active involvement of the public health bureau in increasing participation rates of individuals at risk, primary health care institutions actions to strengthen the coordination of the health promotion program implementation in primary health settings and to initiate collaboration with the public health bureau. The main barriers of the implementation of the health promotion program were identified at systemic, organizational and interpersonal levels: legal regulation; the lack of actions of the municipality doctor and administration of primary health care institutions, ineffective work organization of family physicians, insufficient coordination of the health promotion program in primary health settings, the lack of patients motivation, their and family physicians negative attitudes forwards the implementation of the health promotion program.
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在直辖市实施心血管疾病和糖尿病风险个人健康促进方案:利益相关者的观点
本文分析了Panevėžio市初级卫生保健机构和公共卫生局联合实施的心血管疾病和糖尿病高危人群健康促进方案。采用半结构化访谈法,于2018年1 - 2月对10名签订合作协议的基层卫生保健机构和卫生局代表进行定性研究。在实施健康促进方案方面,初级保健机构与公共卫生局之间的主要合作形式仍然是通过电子邮件发送正式文件,并在初级保健机构举行会议。发展更密切合作的关键先决条件是,公共卫生局积极参与提高高危个人的参与率,初级卫生保健机构采取行动,加强初级卫生保健机构实施健康促进方案的协调,并开始与公共卫生局合作。在系统、组织和人际层面确定了实施健康促进方案的主要障碍:法律法规;市政医生和初级保健机构的管理缺乏行动,家庭医生的工作组织不力,初级保健机构的健康促进方案协调不足,患者缺乏积极性,他们和家庭医生的消极态度阻碍了健康促进方案的实施。
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