title: Towards implementing coordinated healthy lifestyle promotion in primary care: a mixed method study.
abstract: BACKGROUND
  Primary care is increasingly being encouraged to integrate healthy lifestyle promotion in routine care. However, implementation has been suboptimal. Coordinated care could facilitate lifestyle promotion practice but more empirical knowledge is needed about the implementation process of coordinated care initiatives. This study aimed to evaluate the implementation of a coordinated healthy lifestyle promotion initiative in a primary care setting.
  
  
  METHODS
  A mixed method, convergent, parallel design was used. Three primary care centres took part in a two-year research project. Data collection methods included individual interviews, document data and questionnaires. The General Theory of Implementation was used as a framework in the analysis to integrate the data sources.
  
  
  RESULTS
  Multi-disciplinary teams were implemented in the centres although the role of the teams as a resource for coordinated lifestyle promotion was not fully embedded at the centres. Embedding of the teams was challenged by differences among the staff, patients and team members on resources, commitment, social norms and roles.
  
  
  CONCLUSIONS
  The study highlights the importance of identifying and engaging key stakeholders early in an implementation process. The findings showed how the development phase influenced the implementation and embedding processes, which add aspects to the General Theory of Implementation.
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Kristin
authors: K
authors: Thomas
authors: Department of Medical Specialist and Department of Medical and Health Sciences, Linköping University, Motala, Sweden.
authors: Preben
authors: P
authors: Bendtsen
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Barbro
authors: B
authors: Krevers
keywords: General Theory of Implementation; healthy lifestyle promotion; implementation; mixed methods; primary care; process evaluation