The aim of this study is to develop a model of the decision-making process used by GPs when screening for and managing SNAP risk factors in patients presenting for a health check with more than one SNAP risk factor, and use this model to develop and test a framework for supporting GPs in behavioural risk factor screening and management.

Project Status

Completed Projects

Chief Investigators

Cheryl Amoroso

Associate Investigators

Mark Harris, Vanessa Rose, Jane Taggart, Suzanne McKenzie

Rationale

Smoking, nutrition, alcohol, and physical activity are behavioural risk factors which are responsible for a substantial portion of chronic disease and resulting morbidity and mortality in the Australian population. The focus on chronic disease prevention is increasing in Australia, which is reflected in The Council of Australian Governments’ recent Plan for Better Health for All Australians and the National Chronic Disease Strategy, both of which identify the importance of promoting healthy lifestyles; including addressing issues across smoking, nutrition, alcohol use, and physical activity in general practice.

Furthermore, in late 2006, the Commonwealth launched a new rebate item in general practice which will provide funding for GPs to offer a one time preventive health check to patients between the ages of 45 and 49 who are at risk for chronic disease. While there is increasing global attention to encouraging primary health care providers to provide preventive care with regard to screening and managing these risk factors, the factors which influence GPs in making these decisions are currently unknown.

Aim

The aim of this study is to develop a model of the decision-making process used by GPs when screening for and managing SNAP risk factors in patients presenting for a health check with more than one SNAP risk factor, and use this model to develop and test a framework for supporting GPs in behavioural risk factor screening and management.

Design and Method

This is an exploratory study. The paucity of existing knowledge and literature on GP decision-making in the screening and management of chronic disease risk factors meant that qualitative methods were appropriate for this study.

Recruitment & Participants: All GPs from the eight practices who are currently taking part in the 45-49 year old Health Check Study will be invited by letter to take part in this study, with the aim of recruiting between six and ten GPs. Patients of these participating GPs who have had a recent Health Check will be randomly selected and invited to participate, with the aim to recruit two patients per GP. Participation for patients involves consenting to their health check consultation being discussed by the GP and the researcher. Up to 20 patient cases in decision-making will be accessed through this method.

Data collection: A semi-structured interview will be conducted to allow the GP to describe in detail the consultation, with probes used where needed to address
• the factors which influence which SNAP risk factors are screened and managed,
• the order in which the GP addresses multiple risk factors,
• the choice to provide referral versus in-practice advice, and
• barriers/enablers to screening/managing the SNAP risk factors.

Questions will be framed to reflect the cognitive decision-making process identified in the Theory of Planned Behaviour. The interviews will occur within a month of the patients’ health check visits about which the GP will be interviewed.

After the investigators and researcher have analysed the GP interviews and developed a ‘SNAP decision-making model’, a protocol to support SNAP screening and management in general practice will be developed based on the model. The researcher will then conduct a second interview with the GPs to assess the perceived usefulness and acceptability of the support protocol. GP opinions will be incorporated in the final support framework.

Contact

Mandy Ampt Email: m.ampt@unsw.edu.au

Key Partners

Central Sydney and South Eastern Divisions of General Practice

Funding

UNSW Medicine Faculty Research Grant

Project lead centre
CPHCE
Project stream
Prevention and Management of Long Term Conditions
Project start date
2007
Project end date
2007