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Table 2 Targets, actions and agents of the new PVS programs to promote physical activity, healthy diet and smoking cessation in primary and community care

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

Specific behavioral-cognitive objectives Intervention actions Who and How
Identify unhealthy lifestyle behavior and at-risk population Identify attitudes and intention to change to healthier lifestyles A1 assess: assessment of healthy lifestyle behavior and intention to change Population self-evaluation through web-based questionnaire linked to electronic health record PVS questionnaires provided to eligible population at the health care center or through community resources (schools, sport facilities, collaborating companies, etc.) Data entry into the electronic health record by scanning by administrative staff or manually by clinicians
Increase perceptions of severity of risks and vulnerability associated with unhealthy lifestyles Strengthen beliefs and knowledge regarding healthy lifestyles and their positive consequences Increase intention to change behavior Strengthen positive beliefs and knowledge regarding healthy lifestyle at the community level A2 advise: personalized verbal advice centered on the benefits and risks of lifestyle choices A3 agree: assessment of intention to change behavior and agreement of general change goals Physicians or nursesa, guided by PVS software tools included in the clinical information system in routine or scheduled appointments A four-page pamphlet summarizing the abovementioned information on benefits, risks, motivation, and help offered by health care professionals Communication and diffusion of information strategies such as informal talks given by health care professionals in community settings
Enhance self-efficacy perception for behavior change Decrease perception of barriers to behavior change Strengthen coping skills and self-management abilities to facilitate behavior change Improve knowledge regarding community resources to facilitate and support behavior change and prevent relapse A4 assist: reinforcement of reasons and intention to change Identification of barriers to and solutions for behavior change Prescription of a behavior change plan through specific goal setting and action planning, including a self-monitoring log Nursesb assisted by PVS software, which includes tools for action planning, time management, database with contact information for community resources, and health problem-tailored information (evidence-based information on benefits related to a variety of health problems) Provision of a folder containing a brief guide to behavior change with the printed prescription attached
Increase reinforcement related to progress in behavior change and health improvements Strengthen perception of support for behavior change within health care, family and community contexts A5 arrange follow-up Review of behavior change plan, reinforcement centered on achievements, relapse prevention advice and plan re-design May include referral to community resources Recall system managed by administrative personnel Nursesb in scheduled appointment assisted by PVS software, which includes tools for review and re-design of behavior change plans and a database with contact information for community resources
  1. aIn primary health care center, although in some cases collaborating companies may also do this
  2. bMainly nurses in the primary health care center and/or at collaborating companies, in some cases family physicians may also do this