چکیده (انگلیسی):

Background:Our randomized controlled trial (The BETTER Trial) found that training a clinician to become a Prevention
Practitioner (PP) in family practices improved chronic disease prevention and screening (CDPS). PPs were trained on
CDPS and provided prevention prescriptions tailored to participating patients. For this embedded qualitative study, we
explored perceptions of this new role to understand the PP intervention.
Methods:We used grounded theory methodology and purposefully sampled participants involved in any capacity
with the BETTER Trial. Two physicians and one coordinator in each of two cities (Toronto, Ontario and Edmonton,
Alberta) conducted eight individual semi-structured interviews and seven focus groups. We used an interview guide
and documented research activities through an audit trail, journals, field notes and memos. We analyzed the data using
the constant comparative method throughout open coding followed by theoretical coding.
Results:A framework and process involving external and internal practice facilitation using the new role of PP
was thought to impact CDPS. The PP facilitated CDPS through on-going relationships with patients and practice
team members. Key components included: 1) approachingCDPSinacomprehensivemanner, 2) an individualized
and personalized approach at multiple levels, 3) integrated continuity that included linking the patients and practices
to CPDS resources, and 4) adaptability to different practices and settings.
Conclusions:The BETTER framework and key components are described as impacting CDPS through a process that
involved a new role, the PP. The introduction of a novel role of a clinician within the primary care practice with skills
in CDPS could appropriately address gaps in prevention and screening.