ArticleBMC nursing2026
Reimagining community health nursing: a qualitative participatory action research study of nurse-led primary healthcare innovation in rural Saudi Arabia.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundRural primary healthcare (PHC) systems face persistent challenges related to access, continuity, and responsiveness, particularly in geographically dispersed communities. Nurses constitute the backbone of rural PHC delivery in Saudi Arabia, yet their leadership role in driving locally grounded innovation remains underexplored.
aimThis study aimed to examine how nurses lead and sustain primary healthcare innovation in rural Saudi Arabia using a participatory action research (PAR) approach.
methodsA qualitative PAR design was employed with 12 registered nurses working in rural PHC centers. The study unfolded across three iterative cycles of planning, action, observation, and reflection. Data were generated through focus group discussions, in-depth interviews, reflective field notes, and documentation of implemented actions. Reflexive thematic analysis was conducted concurrently with data collection, with participants actively involved in interpretation and refinement of findings.
resultsFour interconnected themes were identified: (1) leading from the frontline through locally grounded innovation; (2) co-creating solutions with patients and communities; (3) working within rural constraints through adaptive practices; and (4) organizational enablement as a condition for sustainability. During PAR Cycles 2 and 3, nurses implemented and refined ten practice innovations targeting continuity of care, patient engagement, workflow efficiency, documentation burden, and team learning. Sustainability was strongest when innovations were selective, simple, and embedded into routine workflows and protocols.
conclusionNurses in rural Saudi Arabia act as key agents of primary healthcare innovation through incremental, relationship-centered changes grounded in everyday practice. Participatory action research offers a robust framework for strengthening nurse leadership, aligning service improvement with community realities, and supporting sustainable rural PHC transformation. Policy and organizational strategies should explicitly enable nurse-led, participatory innovation to advance equitable community health outcomes.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.