Action research: A useful method of promoting change in primary care?

Abstract

Background. Action research has been used successfully to promote change in disciplines other than medicine, but there are few examples of its use in primary care. Objective. We aimed to discuss the benefits and difficulties of using action research in primary care using the example of child health surveillance provision in general practice. Methods. Twenty-eight general practices were randomly allocated into two groups. Action research was used to promote change in 14 practices by facilitating practice meetings and by providing written feedback. The other 14 practices received written feedback alone. The two groups of practices were compared using the following: (i) semi-structured interviews with one health visitor and GP from each practice; (ii) observation of baby clinics; (iii) questionnaires to parents; and (iv) return rates of child health surveillance reviews from the personal child health record. Results. All 14 practices in the action research arm of the study met as individual practice teams and decided to make changes to their provision of child health surveillance. Ten practices audited their child health surveillance as a result. More health visitors in the action research practices than in the comparison practices reported changes to child health surveillance, audit, communication and use of the personal child health record. The majority of health visitors and GPs thought involvement in the action research process was beneficial. However, we were unable to show a statistically significant difference between the two groups of practices in baby clinic provision, parent satisfaction or the return rate of child health surveillance reviews. Conclusion. Our study suggests that action research is a successful method of promoting change in primary care. However, measuring the impact of change is difficult.