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RESEARCH ARTICLE (Open Access)
Contents Vol 30(1)

Exploring organisational readiness to implement a preventive intervention in Australian general practice for overweight and obese patients: key learnings from the HeLP-GP trial

Sharon Parker https://orcid.org/0000-0001-7904-6420 A * , An Tran A , Shoko Saito A , Carmel McNamara https://orcid.org/0000-0002-3321-764X B , Elizabeth Denney-Wilson https://orcid.org/0000-0001-9879-4969 C , Don Nutbeam D , Mark Fort Harris https://orcid.org/0000-0002-0705-8913 A and on behalf of the Health e-Literacy for Prevention in General Practice (HeLP-GP) Trial Group
+ Author Affiliations
- Author Affiliations

A Centre for Primary Health Care and Equity, The University of NSW, Sydney, NSW 2052, Australia.

B Discipline of General Practice, The University of Adelaide, Adelaide, SA 5005, Australia.

C Sydney Local Health District and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.

D School of Public Health, University of Sydney, Sydney, NSW 2006, Australia.

* Correspondence to: Sharon.Parker@unsw.edu.au

Australian Journal of Primary Health 30, PY23085 https://doi.org/10.1071/PY23085
Submitted: 24 July 2023  Accepted: 13 January 2024  Published: 8 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The HeLP-GP trial aimed to increase the capacity of practice nurses to deliver weight management to overweight and obese patients through an intervention comprising a health check, a lifestyle app and/or telephone coaching. This paper describes implementation through the lens of organisational readiness with emphasis on the role of the practice nurse.

Methods

Routinely collected mixed method research data including practice surveys, field notes, and diaries and process data were mapped against the domains: motivation to implement, general capacity and intervention-specific capacity.

Results

Organisational readiness varied considerably, particularly the domain of intervention-specific capacity. Practice nurse turnover negatively impacted the implementation, affecting half of the practices. We observed a general lack of practice-based support for intervention delivery, and varying levels of interest, skill and confidence in delivering the intervention. Nurses struggled to complete the research and intervention tasks in a timely way. Conducting risk assessments and referring to coaching were generally not problematic; however, we noted lower confidence levels with the lifestyle app and instructing patients to use it.

Conclusions

We found a lack of general ‘readiness’ inherent in the nursing role, particularly related to their capacity to complete intervention tasks and practice-level support to implement the intervention. For nurses in general practice to fulfil their potential in supporting patients to reduce risk and adopt healthier life choices, our study indicates that more could be done to improve their workforce positioning and remuneration, which may, in turn, improve continuity of care, retention and individual motivation.

Keywords: family practice, general practice nurse, obesity, organisational readiness, overweight, practice nurse, primary care, primary health, weight management.

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