Implementing social interventions in primary care in Canada: A qualitative exploration of lessons learned from leaders in the field

PLoS One. 2023 Feb 16;18(2):e0281112. doi: 10.1371/journal.pone.0281112. eCollection 2023.

Abstract

Purpose: Primary health care providers and practices are increasingly instituting direct interventions into social determinants of health and health inequities, but experiences of the leaders in these initiatives remain largely unexamined.

Methods: Sixteen semi-structured interviews with Canadian primary care leaders in developing and implementing social interventions were conducted to assess barriers, keys to success, and lessons learned from their work.

Results: Participants focused on practical approaches to establishing and maintaining social intervention programs and our analysis pointed to six major themes. A deep understanding of community needs, through data and client stories, forms a foundation for program development. Improving access to care is essential to ensuring programs reach those most marginalized. Client care spaces must be made safe as a first step to engagement. Intervention programs are strengthened by the involvement of patients, community members, health team staff, and partner agencies in their design. The impact and sustainability of these programs is enhanced by implementation partnerships with community members, community organizations, health team members, and government. Health providers and teams are more likely to assimilate simple, practical tools into practice. Finally, institutional change is key to establishing successful programs.

Conclusion: Creativity, persistence, partnership, a deep understanding of community and individual social needs, and a willingness to overcome barriers underlie the implementation of successful social intervention programs in primary health care settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Canada
  • Humans
  • Primary Health Care*
  • Qualitative Research
  • Social Work*

Grants and funding

The development of this article was supported by funding from the AMS Foundation, St. Michael’s Hospital Department of Family and Community Medicine, The University of Toronto Department of Family and Community Medicine and the College of Family Physicians of Canada. The AMS Foundation, the St. Michael’s Hospital Department of Family and Community Medicine and the University of Toronto Department of Family and Community Medicine provided salary support for GB. All funders provided research funds used to hire LR as a qualitative health researcher. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.