To assess organizational readiness of primary healthcare providers to refer Brazilian public health (SUS) users with chronic musculoskeletal pain for an online pain education program at the secondary level of care.
This is a cross-sectional study using an online survey and it was approved by the Research Ethics Committee. We used the Organizational Readiness for Implementing Change questionnaire (ORIC-Br) to assess organizational readiness of primary healthcare providers to refer SUS users with chronic musculoskeletal pain for an online pain education program (EducaDor program) at the secondary level of care, in Guarapuava city, Brazil. We interpreted the domains of change efficacy and change commitment in terms of means (mean scores ≥4 indicates ready for implementation change in each domain) or proportions (≥50% of respondents considering scores ≥4 for each domain). Guarapuava city has 33 primary healthcare named Family Health teams. Fourteen of this Family Health teams has multidisciplinary teams. To explain the EducaDor program, we first brought together the primary healthcare managers and then the primary healthcare providers from multidisciplinary teams. Then, we visited all 33 Family Health teams. Descriptive analyses were used to depict respondent characteristics and overall ORIC-Br scores.
A total of 155 primary healthcare providers participated in the study (39.2 ±10.6 years old, 87.7% [n=136] women). 65 of them (41.9%) work at Family Health teams only and 90 (58.1%) work at Family Health teams with multidisciplinary team. The mean of ORIC-Br score was 3.4±1.1 (95% CI: 3.2 to 3.5). Primary healthcare units that have Family Health team only seem to be not ready for implementing change in terms of efficacy (64.6%, n=42) and commitment (63.1%, n=41). Family Health teams with multidisciplinary team seem to be more ready for implementing change in terms of commitment (50%, n=45) and not ready in terms of efficacy (52.3%, n=47). Seventeen Family Health teams were not ready for implementing change in terms of commitment and efficacy, four of which had support of multidisciplinary team. Twelve Family Health teams were ready for implementing change in both terms, nine of which had support of multidisciplinary team. Two Family Health teams were ready for implementing change in terms of efficacy but not in terms of commitment and two Family Health teams did not assess the survey.
Organizational readiness for referring SUS users to the EducaDor program was low in most of the Family Health teams. Family Health teams with support of multidisciplinary team seems to be more ready for implementing the innovation.
These results evidence the need to improve strategies for increasing organizational readiness to refer SUS users to the EducaDor program especially in Family Health teams only. It is essential to refine pre-implementation strategies, like continuous education for providers and monitoring of key indicators.
pain education
primary care
