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Table 1 Steps in the collaborative modeling of the PVS implementation strategy under a participatory action research framework involving primary care staff and community members supported by external facilitation provided by the research team

From: Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care

Implementation goals Contents and activities Techniques of consensus, planning, quality improvement and evaluation
1st—descriptive stage (three or four 90–120 min sessions)
 To obtain the commitment of the majority of the professionals to a common health promotion goal, after prioritizing which behaviors and groups to target Presentation of PVS objectives and plan
Assessment of attitudes, perceived practice and organizational climate in the primary health care center
Gathering of information on general and local epidemiology of unhealthy behaviors
Strategic evaluation of healthy lifestyle promotion practice (audit and feedback)
Individual identification of areas for improvement (gaps and needs assessment)
Prioritization and consensus (nominal group)
2nd—creative stage (three 90–120 min sessions)
 To acquire competence in planning the preliminary intervention program: specify objectives and actions, and identify agents and resources involved Analysis of determinants of behavior
Review of evidence-based interventions
Tailoring of interventions to the actual context of the center
Redesign of workflows and staff roles
Educational sessions on theoretical models and health promotion interventions
Group discussion—consensus and planning
 Specific objectives (behavior determinants)
 Mapping of actions and interventions
Redistribution of tasks and responsibilities: what, who, how, when and where
3rd—piloting stage (four to six 90–120 min sessions)
 To achieve active cooperation among the multidisciplinary team within the center and with community agents, optimization of intervention components and their sustainable integration Practical exercise of implementing intervention actions in real-world conditions, for the identification of feasible strategies
Monitoring of performance measures
Standardization of preliminary program on the basis of feasibility
Brief Plan-Do-Study-Act cycles for piloting
Audit and feedback in group sessions
Learning sessions to identify readjustments
Strategic evaluation of the center’s capability to address the planned programs and availability of resources necessary for their implementation (SWOT matrix)