Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care
Artikel i vetenskaplig tidskrift, 2018

Background: Evidence-based practice for healthy lifestyle promotion in primary health care is supported internationally by national policies and guidelines but implementation in routine primary health care has been slow. Referral to digital interventions could lead to a larger proportion of patients accessing structured interventions for healthy lifestyle promotion, but such referral might have unknown implications for clinicians with patients accessing such interventions. This qualitative study aimed to explore the perceptions of clinicians in primary care on healthy lifestyle promotion with or without digital screening and intervention. Methods: Focus group interviews were conducted at 10 primary care clinics in Sweden with clinicians from different health professions. Transcribed interviews were analyzed using content analysis, with inspiration from a phenomenological-hermeneutic method involving naïve understanding, structural analysis and comprehensive understanding. Results: Two major themes captured clinicians' perceptions on healthy lifestyle promotion: 1) the need for structured professional practice and 2) deficient professional practice as a hinder for implementation. Sub-themes in theme 1 were striving towards professionalism, which for participants meant working in a standardized fashion, with replicable routines regardless of clinic, as well as being able to monitor statistics on individual patient and group levels; and embracing the future with critical optimism, meaning expecting to develop professionally but also being concerned about the consequences of integrating digital tools into primary care, particularly regarding the importance of personal interaction between patient and provider. For theme 2, sub-themes were being in an unmanageable situation, meaning not being able to do what is perceived as best for the patient due to lack of time and resources; and following one's perception, meaning working from a gut feeling, which for our participants also meant deviating from clinical routines. Conclusions: In efforts to increase evidence-based practice and lighten the burden of clinicians in primary care, decision- and policy-makers planning the introduction of digital tools for healthy lifestyle promotion will need to explicitly define their role as complements to face-to-face encounters. Our overriding hope is that this study will contribute to maintaining meaningfulness in the patient-clinician encounter, when digital tools are added to facilitate patient behavior change of unhealthy lifestyle behaviors.

Clinician experiences


Digital interventions

Primary care

Qualitative research

Healthy lifestyle promotion

Phenomenological hermeneutics


Anne H. Berman

Stockholms läns landsting

Stockholm Center for Dependency Disorders

Karoline Kolaas

Stockholms läns landsting

Gustavsberg Primary Care Clinic

Elisabeth Petersén

Stockholm Center for Dependency Disorders

Stockholms läns landsting

Preben Bendtsen

Linköpings universitet

Erik Hedman

Gustavsberg Primary Care Clinic

Stockholms läns landsting

Catharina Linderoth

Linköpings universitet

Ulrika Müssener

Linköpings universitet

Kristina Sinadinovic

Stockholms läns landsting

Stockholm Center for Dependency Disorders

Fredrik Spak

Göteborgs universitet

Ida Gremyr

Chalmers, Teknikens ekonomi och organisation, Service Management and Logistics

Anna Thurang

Stockholms läns landsting

Stockholm Center for Dependency Disorders

BMC Family Practice

1471-2296 (ISSN)

Vol. 19 1 139


Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

Medicinsk etik




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