Reach of “VAMOS” program in basic healthcare - organizational barriers and facilitators

Abstract Objective : To investigate the organizational barriers and facilitators to the reach of the “Active Life Health Improvement Program” (or VAMOS) implemented in two Basic Health Units (BHU) in Santa Catarina, Brazil. Method : An experimental study was carried out, based on the RE-AIM framework (http://www.re-aim.org/). Barriers and facilitators were identified through a focus group, semi-structured interview and content analysis. Results : In terms of reach, of the 297 Basic Health Care (BHC) users from the two BHU, 51 elderly people participated, a rate of 17.2%. One notable barrier identified was the lack of support from health teams, while the recommendation of the program by health professionals was found to be a facilitator. Conclusion : The VAMOS program has the potential to be incorporated as a public policy in the process of health care and promotion in BHC. It is an unprecedented strategy in Brazil, aimed at behavioral change, using a sustainable system, the BHU, which has a considerable population reach.

摘要：
研究目的：旨在探究巴西圣卡塔琳娜州两家基层卫生单位（Basic Health Units，BHU）所推行的“积极生活健康改善计划（Active Life Health Improvement Program，简称VAMOS）”在推广落地过程中的组织层面阻碍因素与促进因素。
研究方法：本研究以RE-AIM框架（http://www.re-aim.org/）为基础开展实验性研究，通过焦点小组访谈、半结构化访谈及内容分析法，识别相关阻碍与促进因素。
研究结果：就项目覆盖情况而言，两家基层卫生单位的297名基本卫生保健（Basic Health Care，BHC）服务使用者中，共有51名老年人参与，参与率达17.2%。研究识别出的一项显著阻碍因素为医疗团队支持不足，而卫生专业人员对该项目的推荐则为促进因素之一。
研究结论：VAMOS项目具备被纳入基层卫生保健与健康促进领域公共政策的潜力。该项目是巴西国内针对行为改变、依托可持续基层卫生单位体系开展的一项前所未有的策略，具备可观的人群覆盖规模。