title: Secondary stroke prevention best practice recommendations: exploring barriers for rural family physicians.
abstract: BACKGROUND
  Patients' risk of having a second stroke can be substantially reduced by implementing best practice recommendations for secondary stroke prevention. However, evidence indicates that rural practitioners may face barriers to implementing these recommendations into their practices. This research project developed a workshop to increase practitioner awareness of the recommendations, and to identify barriers to the application of recommendations for secondary prevention of stroke in rural practices.
  
  
  METHODS
  The workshop provided a venue for family physicians, specialists and health district representatives to discuss the recommendations. It was evaluated using a sequential explanatory mixed-methods approach using 3 methods of data collection: a questionnaire, documentation of comments made during discussion periods and post-workshop interviews.
  
  
  RESULTS
  Participants at the workshop increased their awareness of the recommendations, and they gained an increased appreciation of how they might collaborate with other practitioners and the health district to implement the recommendations. The workshop identified barriers to implementing recommendations, such as miscommunications with the local health district, role conflict among physicians regarding health promotion and difficulties coordinating care with specialists.
  
  
  CONCLUSIONS
  The workshop was an effective venue for improving communication between physicians and the health district and for reducing barriers to the implementation of recommendations.
authors.affiliation: Atlantic Health Promotion Research Centre, Dalhousie University, Halifax, NS. grace.warner@dal.ca
authors.forename: Grace
authors.initials: G
authors.lastname: Warner
authors.forename: Jessie
authors.initials: J
authors.lastname: Harrold
authors.forename: Michael
authors.initials: M
authors.lastname: Allen
authors.forename: Renee
authors.initials: R
authors.lastname: Lyons
mesh_terms: D001291:Attitude of Health Personnel; D019985:Benchmarking; D002170:Canada; D005194:Family Practice / Q000193:education / Q000458:organization & administration / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D010821:Physicians, Family / Q000193:education / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000458:organization & administration* / Q000706:statistics & numerical data; D011365:Professional Practice Location; D011369:Professional-Patient Relations; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D020521:Stroke / Q000517:prevention & control*