[What are we doing in neighborhoods? Description of health-promoting community activities in primary care: the FrAC Project]

Abstract

Objective: To describe the health-promoting community activities developed in primary health care and compare types of activities and how they are performed among autonomous regions.

Methods: A descriptive multicenter study was carried out in primary care in 5 Spanish regions. We included community activities consisting of non-sporadic activities, carried out in the previous year, with the participation of the primary care team, and the active participation of the community or as a cross-sector activity. The persons responsible for each of the 194 teams were asked if the team participated in community activities and, if so, a questionnaire was completed by the person responsible for each activity. The variables consisted of the topic addressed, the target population, the professionals involved, the time and scope of implementation, evaluation, theoretical perspectives, network registration, the involvement of the community and other agents, and evaluation of this involvement. A descriptive analysis was performed, stratified by region.

Results: We identified 183 community activities in 104 teams. Although there was wide variability among regions, most activities were related to general health, nutrition and emotional-sexual health and targeted the general population, children or parents and were carried out in educational or health centers. Participating professionals had a median of 4 years of experience and a median of 2.8 professionals were involved in each activity. A total of 72.5% of the activities were performed during working hours, 75% were evaluated, and 70% were supported by theoretical and methodological perspectives. Non-health sectors were involved in 65%, local government in 60%, and nongovernmental organizations in 58.5%. Nurses were involved in 85.8% of the activities, physicians in 38.5%, and social workers in 35%. Substantial variability was detected among regions.

Discussion: Wide variability was found in the types of activities and their application among the community activities developed by primary care, as well as in institutional recognition and community involvement in the development and evaluation of these activities.

Keywords: Atención primaria; Community; Community interventions; Comunidad; Health promotion; Health service research; Intervenciones comunitarias; Investigación en servicios de salud; Primary health care; Promoción de la salud.