Evidence map›Paper›PMID 41572196›Full record

ArticleBMC primary care2026

Act in time: primary health care professionals', internal facilitators', and managers' experiences of working health-promotively after a 12-month implementation intervention: a qualitative study using normalization process theory.

Berntsson Karin, Nilsagård Ylva, Hälleberg-Nyman Maria, Wallin Lars, Nilsing Strid Emma

Abstract read
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Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Berntsson KarinUniversity Healthcare Research Centre, Faculty of Medicine and Health, Post Graduate School for Integrated Care, Örebro University, Örebro, SE-701 85, Sweden. karin.berntsson@oru.se.ORCID 0009-0001-1110-5284
Nilsagård YlvaUniversity Healthcare Research Centre, Faculty of Medicine and Health, Post Graduate School for Integrated Care, Örebro University, Örebro, SE-701 85, Sweden.ORCID 0000-0002-9760-3785
Hälleberg-Nyman MariaUniversity Healthcare Research Centre, Faculty of Medicine and Health, Post Graduate School for Integrated Care, Örebro University, Örebro, SE-701 85, Sweden.ORCID 0000-0003-0460-3864
Wallin LarsDepartment of Health and Welfare, Dalarna University, Falun, SE-791 88, Sweden.ORCID 0000-0001-9035-0669
Nilsing Strid EmmaUniversity Healthcare Research Centre, Faculty of Medicine and Health, Post Graduate School for Integrated Care, Örebro University, Örebro, SE-701 85, Sweden.ORCID 0000-0002-0483-8981

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealthy-lifestyle-promoting practices are recommended to reduce the prevalence of non-communicable diseases and increase health, but are underutilized in Swedish primary health care (PHC). As part of the Act in Time project, a 12-month multifaceted implementation intervention to support the uptake of a clinical intervention offering lifestyle-screening forms and counselling to patients with planned visits, was evaluated in a PHC setting. This study aimed to explore the experiences of PHC professionals, internal facilitators, and managers working with health promotion after receiving the 12-month implementation intervention.

methodsA qualitative study was conducted at five PHC units in Sweden using interviews with managers (n = 9) and internal facilitators (n = 10) and focus group discussions (n = 5) with physicians, nurses, counsellors, and physiotherapists (n = 18). The data were analysed with qualitative content analysis, first inductively and then deductively by mapping the data against the 12 constructs of Normalization Process Theory.

resultsImplementation of the health-promoting practice was affected by contextual factors such as attitudes and available resources. The group dynamics at the PHC centres and the managers’ role as leaders were important for finding solutions to enact the health-promotion practice. Health-promotion practice was seen as a natural development of PHC. A common focus and opportunity to influence created a sense of coherence. Feelings of autonomy enabled the professionals to collaborate and strengthened participation in the implementation intervention. The internal facilitators helped to guide the PHC centres forward in the implementation process and created strategies to integrate the health-promotion practice into existing clinical practice. Uptake of the clinical intervention led to a more structural and holistic way of working with lifestyle habits, with patients taking an active part. The professionals’ competencies became more visible by working together, but frustration was also expressed due to different levels of engagement in the health-promotion practice.

conclusionsHealth-promotion practice can be normalized as routine work in PHC with targeted support but requires tailored strategies that rely on existing group dynamics and the manager’s role. To create motivation for providing health promotion, inter-professional collaboration is a key factor that ensures shared ownership of the implementation intervention.

trial registrationThis study is part of the Act in Time project, registered at ClinicalTrials.gov on 4 March 2021 (ref NCT04 799860).

Indexed as

Attitude of Health PersonnelHealth PersonnelHealth PromotionPrimary Health CareFemaleFocus GroupsGroup DynamicsHealthy LifestyleHumansMaleQualitative ResearchSwedenHealth promotionImplementation sciencePrimary health careQualitative research

Identifiers

PMID41572196
PMCPMC12857077

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.