Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial.

Abstract:

BACKGROUND:The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be based upon the training of health professionals. Following the recommendations of a breastfeeding guide can modify the practice of health professionals and improve results with respect to exclusively or predominatly breastfed children at 6 months of age. METHOD/DESIGN:This study involves a community based cluster randomized trial in primary healthcare centres in Leganés (Madrid, Spain). The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader) of a breastfeeding guideline in primary care is more effective than usual diffusion. The number of patients required will be 240 (120 in each arm). It will be included all the mothers of infants born during the study period (6 months) who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age..Main effectiveness will be analyzed by comparing the percentage of infants with exclusive or predominant breastfeeding at 6 months between the intervention group and the control group. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. DISCUSSION:Strategies need to be found which facilitate the giving of effective advice on breastfeeding by professionals and which provide support to women during the breastfeeding period. By applying the guide's recommendations, clinical variability can be reduced and the care received by patients can be improved. TRIAL REGISTRATION:The trial was registered with ClinicalTrials.gov, number NCT01474096.

journal_name

BMC Fam Pract

journal_title

BMC family practice

authors

Martín-Iglesias S,del-Cura-González I,Sanz-Cuesta T,Arana-Cañedo Argüelles C,Rumayor-Zarzuelo M,Alvarez-de la Riva M,Lloret-Sáez Bravo AM,Férnandez-Arroyo RM,Aréjula-Torres JL,Aguado-Arroyo Ó,Góngora-Maldonado F,García-Corraliza M

doi

10.1186/1471-2296-12-144

subject

Has Abstract

pub_date

2011-12-30 00:00:00

pages

144

issn

1471-2296

pii

1471-2296-12-144

journal_volume

12

pub_type

杂志文章,随机对照试验
  • Staff perceptions of addressing lifestyle in primary health care: a qualitative evaluation 2 years after the introduction of a lifestyle intervention tool.

    abstract:BACKGROUND:Preventive services and health promotion in terms of lifestyle counselling provided through primary health care (PHC) has the potential to reduce morbidity and mortality in the population. Health professionals in general are positive about and willing to develop a health-promoting and/or preventive role. A n...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-99

    authors: Carlfjord S,Lindberg M,Andersson A

    更新日期:2012-10-10 00:00:00

  • The management of non-valvular atrial fibrillation (NVAF) in Australian general practice: bridging the evidence-practice gap. A national, representative postal survey.

    abstract:BACKGROUND:General practitioners (GPs) are ideally placed to bridge the widely noted evidence-practice gap between current management of NVAF and the need to increase anticoagulant use to reduce the risk of fatal and disabling stroke in NVAF. We aimed to identify gaps in current care, and asked GPs to identify potentia...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-62

    authors: Gattellari M,Worthington JM,Zwar NA,Middleton S

    更新日期:2008-11-13 00:00:00

  • Impact of NPS MedicineWise general practitioner education programs and Choosing Wisely Australia recommendations on prescribing of proton pump inhibitors in Australia.

    abstract:BACKGROUND:This study evaluated the impact of multifaceted NPS MedicineWise programs that targeted all general practitioners (GPs) in Australia in 2009 and 2015 with the aim of reducing unnecessary prescribing of proton pump inhibitors (PPIs) and encouraged stepping down to a lower strength PPI or to discontinue treatm...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01158-1

    authors: Wu J,Dickinson S,Elgebaly Z,Blogg S,Heaney A,Soo Y,Daniels B,Weekes L

    更新日期:2020-05-09 00:00:00

  • Efficacy of a strategy for implementing a guideline for the control of cardiovascular risk in a primary healthcare setting: the SIRVA2 study a controlled, blinded community intervention trial randomised by clusters.

    abstract:UNLABELLED:This work describes the methodology used to assess a strategy for implementing clinical practice guidelines (CPG) for cardiovascular risk control in a health area of Madrid. BACKGROUND:The results on clinical practice of introducing CPGs have been little studied in Spain. The strategy used to implement a CP...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-12-21

    authors: Rodríguez-Salvanés F,Novella B,Fernández Luque MJ,Sánchez-Gómez LM,Ruiz-Díaz L,Sánchez-Alcalde R,Sierra-García B,Mayayo S,Ruiz-López M,Loeches P,López-Gónzález J,González-Gamarra A,SIRVA2 group.

    更新日期:2011-04-19 00:00:00

  • The University of Limerick Education and Research Network for General Practice (ULEARN-GP): practice characteristics and general practitioner perspectives.

    abstract:BACKGROUND:A well-functioning general practice sector that has a strong research component is recognised as a key foundation of any modern health system. General practitioners (GPs) are more likely to collaborate in research if they are part of an established research network. The primary aims of this study are to desc...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-1100-y

    authors: O'Regan A,Hayes P,O'Connor R,Casey M,O'Dwyer P,Culhane A,O'Donnell P,Stack G,Cuddihy J,O'Connell B,O'Flynn J,Cullen W,O'Doherty J,O'Connell M,Glynn L

    更新日期:2020-02-05 00:00:00

  • Tools for measuring patient safety in primary care settings using the RAND/UCLA appropriateness method.

    abstract:BACKGROUND:The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcar...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-110

    authors: Bell BG,Spencer R,Avery AJ,Campbell SM

    更新日期:2014-06-05 00:00:00

  • Knowledge, attitudes, and practices of primary health care physicians regarding the pre-travel counselling of patients with type 2 diabetes in Riyadh, Saudi Arabia.

    abstract:BACKGROUND:Travel has become an integral part of Saudi life. People with diabetes face many challenges while travelling that can have detrimental effects on glycaemic control. However, no previous studies have investigated pre-travel counselling in Saudi Arabia. This study aims to assess the knowledge, attitudes and pr...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01273-z

    authors: Alduraibi RK,Almigbal TH,Alrasheed AA,Batais MA

    更新日期:2020-09-24 00:00:00

  • Cluster randomized, controlled trial on patient safety improvement in general practice: a study protocol.

    abstract:BACKGROUND:An open, constructive safety culture is key in healthcare since it is seen as a main condition for patient safety. Studies have examined culture improvement strategies in hospitals. In primary care, however, not much is known about effective strategies to improve the safety culture yet. The purpose of this s...

    journal_title:BMC family practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/1471-2296-14-127

    authors: Verbakel NJ,Langelaan M,Verheij TJ,Wagner C,Zwart DL

    更新日期:2013-08-29 00:00:00

  • Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study.

    abstract:BACKGROUND:The prevalence of coexisting chronic conditions (multimorbidity) is rising. Disease labels, however, give little information about impact on subjective health and personal illness experience. We aim to examine the strength of association of single and multimorbid physical chronic diseases with self-rated hea...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-014-0185-6

    authors: Mavaddat N,Valderas JM,van der Linde R,Khaw KT,Kinmonth AL

    更新日期:2014-11-25 00:00:00

  • Preventive Evidence into Practice: what factors matter in a facilitation intervention to prevent vascular disease in family practice?

    abstract:BACKGROUND:A perennial challenge of primary care quality improvement is to establish why interventions work in some circumstances, but not others. This study aimed to identify factors explaining variations in the impact on clinical practice of a facilitation led vascular health intervention in Australian family practic...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s12875-019-0995-7

    authors: Russell G,Lane R,Parker S,Litt J,Mazza D,Lloyd J,Zwar N,van Driel M,Del Mar C,Smith J,Harris MF,Preventive Evidence into Practice (PEP) Partnership Group.

    更新日期:2019-08-08 00:00:00

  • Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study.

    abstract:BACKGROUND:Elderly patients with multimorbidity who are treated according to guidelines use a large number of drugs. This number of drugs increases the risk of adverse drug events (ADEs). Stopping medication may relieve these effects, and thereby improve the patient's wellbeing. To facilitate management of polypharmacy...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-56

    authors: Schuling J,Gebben H,Veehof LJ,Haaijer-Ruskamp FM

    更新日期:2012-07-09 00:00:00

  • Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners.

    abstract:BACKGROUND:Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs)...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-1078-5

    authors: Schmid GL,Kühnast B,Heise M,Deutsch T,Frese T

    更新日期:2020-01-13 00:00:00

  • Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

    abstract:BACKGROUND:Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-10-81

    authors: Cantrell J,Shelley D

    更新日期:2009-12-17 00:00:00

  • An exploratory study of GP awareness of carer emotional needs in Western Australia.

    abstract:BACKGROUND:The impact of caring for a family member or friend is a life changing experience. Often carers are struggling to cope with ongoing demands of caring for someone. At some point, most carers will approach their family physician for advice on aspects of their role. Carers Western Australia sought information an...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-7-33

    authors: Bulsara CE,Fynn N

    更新日期:2006-05-24 00:00:00

  • 'Very brief advice' (VBA) on smoking in family practice: a qualitative evaluation of the tobacco user's perspective.

    abstract:BACKGROUND:Very Brief Advice on smoking (VBA) is an evidence-based intervention designed to increase quit attempts among patients who smoke. VBA has been widely disseminated in general practice settings in the United Kingdom, however its transferability to Southern European settings is not well established. This study ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01195-w

    authors: Papadakis S,Anastasaki M,Papadakaki M,Antonopoulou Μ,Chliveros C,Daskalaki C,Varthalis D,Triantafyllou S,Vasilaki I,McEwen A,Lionis C

    更新日期:2020-06-24 00:00:00

  • An implementation history of primary health care transformation: Alberta's primary care networks and the people, time and culture of change.

    abstract:BACKGROUND:Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01330-7

    authors: Leslie M,Khayatzadeh-Mahani A,Birdsell J,Forest PG,Henderson R,Gray RP,Schraeder K,Seidel J,Zwicker J,Green LA

    更新日期:2020-12-05 00:00:00

  • Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials.

    abstract:BACKGROUND:Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization inter...

    journal_title:BMC family practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s12875-016-0577-x

    authors: Huiskes VJ,Burger DM,van den Ende CH,van den Bemt BJ

    更新日期:2017-01-17 00:00:00

  • Effects of primary care clinician beliefs and perceived organizational facilitators on the delivery of preventive care to individuals with mental illnesses.

    abstract:BACKGROUND:Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, a...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-017-0693-2

    authors: Yarborough BJH,Stumbo SP,Perrin NA,Hanson GC,Muench J,Green CA

    更新日期:2018-01-12 00:00:00

  • Implementing evidence-based medicine in general practice: a focus group based study.

    abstract:BACKGROUND:Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore t...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-6-37

    authors: Hannes K,Leys M,Vermeire E,Aertgeerts B,Buntinx F,Depoorter AM

    更新日期:2005-09-09 00:00:00

  • Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

    abstract:BACKGROUND:A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mo...

    journal_title:BMC family practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s12875-015-0314-x

    authors: Linde K,Rücker G,Sigterman K,Jamil S,Meissner K,Schneider A,Kriston L

    更新日期:2015-08-19 00:00:00

  • Physicians' communication skills with patients and legal liability in decided medical malpractice litigation cases in Japan.

    abstract:BACKGROUND:In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients,...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-43

    authors: Hamasaki T,Takehara T,Hagihara A

    更新日期:2008-07-25 00:00:00

  • Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial.

    abstract:BACKGROUND:Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for man...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-10-9

    authors: Siriwardena AN,Apekey T,Tilling M,Harrison A,Dyas JV,Middleton HC,Ørner R,Sach T,Dewey M,Qureshi ZM

    更新日期:2009-01-26 00:00:00

  • Are osteoporotic fractures being adequately investigated? A questionnaire of GP & orthopaedic surgeons.

    abstract:BACKGROUND:To investigate the current practice of Orthopaedic Surgeons & General Practitioners (GP) when presented with patients who have a fracture, with possible underlying Osteoporosis. METHODS:Questionnaires were sent to 140 GPs and 140 Orthopaedic Surgeons. The participants were asked their routine clinical pract...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-7-7

    authors: Chami G,Jeys L,Freudmann M,Connor L,Siddiqi M

    更新日期:2006-02-07 00:00:00

  • Patients' expectations of acute low back pain management: implications for evidence uptake.

    abstract:BACKGROUND:In many countries, general practitioner (GP) care of acute low back pain often does not adhere to evidence-based clinical guidelines. There has been little exploration of this deviation from evidence-based care from the patients' perspective, particularly in relation to patients' care expectations. The aim o...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-14-7

    authors: Hoffmann TC,Del Mar CB,Strong J,Mai J

    更新日期:2013-01-08 00:00:00

  • Sick leave certification: a unique perspective on frequency and duration of episodes - a complete record of sickness certification in a defined population of employees in Malta.

    abstract:BACKGROUND:In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-4-2

    authors: Soler JK

    更新日期:2003-03-27 00:00:00

  • Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

    abstract:BACKGROUND:Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0392-9

    authors: Bengough T,Bovet E,Bécherraz C,Schlegel S,Burnand B,Pidoux V

    更新日期:2015-12-11 00:00:00

  • Recent trends and variations in general practitioners' involvement in accident care in Switzerland: an analysis of claims data.

    abstract:BACKGROUND:As in other countries, there is concern and some fragmentary evidence that GPs' central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs' involvement in accident care from 2008 to 2016 and identifies chang...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01170-5

    authors: Höglinger M,Knöfler F,Schaumann-von Stosch R,Scholz-Odermatt SM,Eichler K

    更新日期:2020-06-05 00:00:00

  • Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study.

    abstract:BACKGROUND:Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and pat...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-11-47

    authors: Sloma A,Backlund LG,Strender LE,Skånér Y

    更新日期:2010-06-15 00:00:00

  • A systematic review of approaches to improve practice, detection and treatment of unhealthy alcohol use in primary health care: a role for continuous quality improvement.

    abstract:BACKGROUND:Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. T...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-1101-x

    authors: Dzidowska M,Lee KSK,Wylie C,Bailie J,Percival N,Conigrave JH,Hayman N,Conigrave KM

    更新日期:2020-02-13 00:00:00

  • Treating tobacco dependence in older adults: a survey of primary care clinicians' knowledge, attitudes, and practice.

    abstract:BACKGROUND:The benefits of smoking cessation among older people are well documented. Despite this, evidence suggests that older smokers are rarely engaged in smoking cessation efforts, and that existing tobacco dependence treatments require further tailoring to the specific needs of older smokers. This study assesses t...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0317-7

    authors: Huddlestone L,Walker GM,Hussain-Mills R,Ratschen E

    更新日期:2015-08-06 00:00:00