A process evaluation of an intervention to improve respiratory infection control practices in family physician offices

Objective: To conduct a process evaluation of a short-term intervention by public nurses for physicians to facilitate the incorporation of new respiratory infection control practices in physicians' offices. Design: Process evaluation. Setting: Family physician offices in Ottawa, Ontario, Canada. Participants: Five public health nurse-facilitators and 53 primary care practices including 143 family physicians. Method: Effectiveness of facilitator training assessed by self-administered questionnaires. Data assessing process of facilitation collected through activity logs and narrative reports. Physicians' satisfaction assessed by post-intervention questionnaire. Main Findings: Facilitators reported that training strongly contributed to their knowledge and skills and all were either satisfied or highly satisfied with their facilitation training. All practices received at least two visits by the facilitator and more than half (51%) were visited three or more times. Facilitators identified the provision of the evidence-based Tool Kit and consensus-building with office staff as key factors contributing to the intervention's success. Of the 45% of physicians who completed the questionnaire (65/143), only 5% reported being somewhat dissatisfied with the intervention, 11% reported the visits were not frequent enough, and 9% thought the visits were too close together. The majority (97%) felt the facilitation program should be available to all family physicians and 98% would continue to use the service if available. Conclusions: It is feasible for public health nurses to be trained in outreach facilitation to improve respiratory infection control practices in physicians' offices and this has been widely appreciated by physicians. This model of public health/primary care collaboration deserves further exploration.