title: Development of an interprofessional program for cardiovascular prevention in primary care: A participatory research approach.
abstract: BACKGROUND
  The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model-based program of interventions, but no one has as yet offered a description of precisely how to apply the approach.
  
  
  OBJECTIVE
  An innovative, structured, multi-step participatory process was applied to select and develop (1) chronic care model-based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2) a set of indicators to monitor its implementation.
  
  
  METHODS
  Primary care clinicians (n = 16), administrative staff (n = 2), patients and family members (n = 4), decision makers (n = 5), researchers, and a research coordinator (n = 7) took part in the process. Additional primary care actors (n = 26) validated the program.
  
  
  RESULTS
  The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined.
  
  
  CONCLUSIONS
  Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities.
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada; Sanofi Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.
authors.forename: Lyne
authors.initials: L
authors.lastname: Lalonde
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.
authors.forename: Johanne
authors.initials: J
authors.lastname: Goudreau
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Éveline
authors.initials: É
authors.lastname: Hudon
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Lussier
authors.affiliation: HEC Montréal, Montreal, QC, Canada.
authors.forename: Céline
authors.initials: C
authors.lastname: Bareil
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada; Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.
authors.forename: Fabie
authors.initials: F
authors.lastname: Duhamel
authors.affiliation: Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Lévesque
authors.affiliation: Direction of Professional Services, Centre de santé et de services sociaux de Deux-Montagnes, Deux-Montagnes, QC, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Turcotte
authors.affiliation: Médi-Centre Chomedey, Laval, QC, Canada.
authors.forename: Gilles
authors.initials: G
authors.lastname: Lalonde
keywords: Participatory research; cardiovascular diseases; health services; intervention development; knowledge translation; prevention; primary care; risk factors