| Project Objectives / Summary:
The purpose of this project was to reorient general practitioners towards cost-effective, evidence-based health promotion in general practice settings by implementing RACGP guidelines in the context of men's health promotion.
Research has demonstrated a need to change attitudes, structures and environments in general practice and develop sustainable skills, systems and processes for Men's Health Promotion. This project provided intensive support in practices to implement and sustain RACGP Guidelines for "Putting Prevention into Practice". It drew upon local, State and national health promotion policies and guidelines, especially the NEHPC's groundbreaking "Men's Health Promotion Strategic Framework".
The project represented the first opportunity to systematically implement and evaluate the RACGP Guidelines in the context of Men's Health Promotion, and facilitated their networking with local agencies.
As this project was based around population health in general practice, and the principles underlying this are generally found within a social model of health, of which many GPs are unfamiliar, the activities were aimed to create change beyond the limited two-year timeframe of the project. There was a need to highlight practical changes that GPs could make to assist in the health care of men, utilising a social model of health focusing on lifestyle behaviour change interventions and mental health.
A Resource Kit was also developed which was available in hard copy or via the Division's website. For those GPs who wanted more, they participated in the GP Visitors Program, a program using a peer education approach, where a GP colleague, along with the Project Coordinator, would visit a GP in his / her practice and use the Resource Kit to elicit discussions around the issues they faced in their practice regarding men.
Finally, the most intensive part of the project, and by far the most conducive to real and substantial changes in practice, was the Practice Support Program. This used an organisational development approach to improve systems and processes within the practice, on which health promotion systems could be built. It emphasised the need for upskilling within the practice, especially at the "management" level and aimed continually for sustainable change.
Recruitment to such an extensive program was difficult. This program required a great deal from the GPs by way of unpaid time, commitment and to some degree additional money (either for additional resources such as information boards, flyer holders or additional human resources to do the tasks required). For those GPs and practices that did participate, the unpaid time, consistency in commitment and level of workload were issues they all experienced and made the program more difficult to implement.
Project Collaboration:
North East Valley Division worked closely with the Melbourne and Northern Divisions of General Practice.
Project Outcomes:
Early in the project's life, Practices expressed a need for practical measures to assist them. In the first stage of the project, emphasis was given to awareness raising, lifting the skill levels in Practices, and focussing on management systems and the key role of the GP as a manager as well as a clinician. This required a flexible approach as Practices and their personnel differ.
The project used a variety of approaches to achieve this. The Practice Support program, for example, involved work with Practice Managers and GPs in preparing Practice-specific Health promotion Plans. The GP Visitor Program was based on peer education and academic detailing.
While this activity was particularly labour-intensive, it succeeded.
Recommendations:
- That general practices be offered support to establish IT capacity to collect data about, and monitor, the success of recall systems for health assessments.
- That the Melbourne, Northern and North Eastern Valley Divisions work with GPDV and the AMA to promote the establishment of financial incentives for prevention in General Practice.
- That future projects concerned with prevention in General Practice advocate for and provide a structure for patient feedback after the preventative intervention.
- That Melbourne Division be encouraged to establish a Special Interest Group on men's health to promote the ideas and strategies of men's health, and extend the gains resulting from this project.
- That the Melbourne, Northern and North Eastern Valley Divisions report the outcomes of this project to VicHealth and all other relevant agencies with a view to further assisting in the implementation of the Men's Health Framework.
Disseminating Project Information:
A tremendous amount of dissemination occured throughout the course of this project. Please contact the Division directly for specific information in relation to disseminating activities.
Lessons / Assessment:
A key feature of the conduct of this project was the need for intensive personal interaction between the Project Officer, GPs and, importantly, Practice Managers. This demonstrates that attitudinal and systems change requires dedicated resourcing.
|
