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Evaluation of “Live for Life”, a health promotion programme in the County of Skaraborg, Sweden
Health Centre of Habo, Habo, Sweden.
Health Centre of Habo, Habo, Sweden.
Health Centre of Habo, Habo, Sweden.
Department of Primary Health Care, Göteborg University, Vasa Hospital, Gothenburg, Sweden.
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2001 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 55, no 4, 277-282 p.Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVE To evaluate a health promotion programme, combining a population and individual based strategy, in the County of Skaraborg, Sweden, with special attention to outcome.

DESIGN The evaluation was subdivided into structure, process and outcome. The evaluation procedure as a total is described here, but the results presented refer only to outcome. In order to study the potential effect of the individually based health examination, 35 year old subjects who had participated five years previously were in 1994–1996 compared with 35 year old subjects who had not participated before, and compared with their own values five years earlier. The results during 1995–1996 were compared with those of 1989–1990 for corresponding ages in order to study the effect of, particularly, the population based strategy.

SETTING The County of Skaraborg in the south western part of Sweden with about 270 000 inhabitants. In addition to population strategy, involving the total county, men and women aged 30 and 35 years were invited to an individually based examination.

MAIN RESULTS Factors related to body weight increased during the study period, while other factors mostly changed in the direction wanted. As a whole the changes were rather modest. There were favourable changes in lifestyle variables, for example, concerning smoking and dietary habits.

CONCLUSIONS There were beneficial effects from the health promotion programme, but there is a need for continuous improvement of methods of intervention referred to lifestyle.

Place, publisher, year, edition, pages
2001. Vol. 55, no 4, 277-282 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-81485DOI: 10.1136/jech.55.4.277OAI: diva2:552930
Available from: 2012-09-17 Created: 2012-09-17 Last updated: 2012-09-17Bibliographically approved
In thesis
1. Methods for quality development on the primary health care structure
Open this publication in new window or tab >>Methods for quality development on the primary health care structure
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe and analyse methods for quality development of the Swedish primary health care structure. Specific aims were as follows. To describe and test a medical-audit method of determining the optimum level of outpatient medical care. To describe and test the tracer-condition methodology for quality assessment of the medical care delivered by the primary health care. To describe and test a practice-visiting method to compare the total qualities of primary health care centres in order to facilitate quality improvement. To describe and test Donabedian's method (structure, process, outcome) of evaluating a health-promotion programme giving special attention to outcome. To use register data as a method to analyse important determinants of hospitalisation rates and whether the primary health care has any influence.

Different methods for quality development, such as peer review, medical audit, practice-visiting and tracer-condition technique, were used in order to evaluate the quality of care at the primary health care centres and to identify the role of primary health care in the total health care system. Papers I-V were based on studies of everyday activities in ordinary health care centres and hospitals in three counties in southern Sweden during 1987-2000.The methods used were chosen and adapted for the purpose of the studies.

It was agreed upon that about 75% of the outpatient visits to a doctor could be managed by a general practitioner (GP) (Paper I). There was no difference in quality when patients with insulin-treated diabetes mellitus visiting a GP were compared with those visiting a doctor at a hospital (Paper II). Practice-visiting proved to be a suitable method of comparing different primary health care centres with respect to medical quality (Paper III). A health promotion progrannne could be integrated into the everyday work at the health centres and was found to improve lifestyle habits and influence cardiovascular risk factors (Paper IV). The most important determinants of hospitalisation rates were age, the proportion of the population born abroad, the structure of the health care organisation, and the number of outpatient visits to hospital (Paper V).

The different methods which have been described need to be adapted to Swedish primary health care. The methods described in this thesis (medical audit, the tracer-condition method, practice-visiting and Donabedian's method) were usable for the purposes described. Register studies yielded valuable information in analysing important factors for explaining hospitalisations.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 65 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 719
Quality development, primary health care, evaluation, medical audit, tracercondition method, practice-visiting, health promotion, register study
National Category
Social Sciences
urn:nbn:se:liu:diva-26342 (URN)10866 (Local ID)91-7373-161-7 (ISBN)10866 (Archive number)10866 (OAI)
Public defence
2002-07-01, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-17Bibliographically approved

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