RedIAPP - Primary Care Prevention and Health Promotion Network

Presentation

Background

Years 2003-2006

In 2003 the Primary Care Prevention and Health Promotion Network (redIAPP) was constituted in response to the Carlos III Health Institute (ISCiii) call for proposals (G03/170 network) which generated 67 research networks in Spain. For the first time in the history of Primary Care in Spain a network of research groups from 13 autonomous regions was established, thus opening the way to a stable research platform.
The initial structure of redIAPP comprised:
-    15 research nodes  (or wide research groups): almost 500 researchers and professionals involved, 
-    13 autonomus communities
-    7 research areas

After 4 years the results obtanied were: almost 500 researchers and professionals  involved17 network projects57 papers10 doctoral theses12 short stays for trainingmore than 50 courses and workshops organized, and contribution to the development of 6 published guidelines. 
In addition to these results, the redIAPP contributed to the development of research in the regions where their research nodes were located by encouraging policies of support for research in primary care and at the autonomous community management level. The final appraisal done by the International Assessment Board was positive and the continuation of the network was recommended.

Network restrcture in 2006

In 2006 there was a new call for proposals at the ISCiii to continue funding the networks created in 2003. The characteristics of this new call were very different, and the redIAPP was funded again but with only 11 groups and a smaller budget.

RedIAPP had to adapt to this new scenario and had to elaborate a new strategic plan. Two years later 2 more groups were admitted and funded and 2 more were also admitted but without funding; the redIAPP assumed their participation expenses. Furthermore, the network had 23 clinical support groups, with a small budget, in order to carry out support tasks for network projects. During this period, 2007-2012, redIAPP has been organized in 5 research areas (Mental health, Health services research, Lifestyles, Cardiovascular risk factors and Cancer).

The results obtained after 5 years were: 735 investigators (160 in the research groups and 575 in the clinical support groups); 30 network projects: 18 national, 2 European and 10 at the autonomous community level. More than 200 local projects developed by the different groups; 78 papers (IF=158.699). The total scientific production of the groups has been 690 articles (IF=1348.3); Transfer: 21 Clinical Practice Guidelines have been developed, 33 reports completed, and 7 instruments validated; the effectiveness of 8 interventions was evaluated and 12 contracts or agreements reached.



Objectives

redIAPP has this following general objectives:

1.     To evaluate disease prevention and health promotion activities that exist in primary care at the individual, group and community level, and develop innovative preventive interventions related to cardiovascular diseases, cancer, and anxiety and depressive disorders.

2.     To design and implement a clinical trial following the methodology proposed by the Medical Research Council to evaluate the effectiveness and cost-benefit of a multi-factorial and multi-risk intervention for health promotion and disease prevention to reduce the most frequent chronic health conditions and favour active, healthy aging.

3.     To develop and integrate new decision support tools for primary care professionals as well as interventions based on the use of information and communication technologies directed toward health promotion, prevention of chronic health conditions and their transfer to the private sector.

Mision

redIAPP is a research network that aims to generate knowledge that will benefit Primary Care, particularly on the efficacy, effectiveness and efficiency of new interventions in prevention and health promotion. redIAPP aims also to disseminate knowledge so that public, the scientific community and the services coordinators can  integrate the prevention and apply the results to daily clinical practice and service management.

 

Services

WP 1 LS . Activities and interventions related to improving healthy lifestyles

The objective is to evaluate new interventions directed to improving lifestyle choices (tobacco, alcohol, physical activity and diet) and the development of applications and tools to achieve them. Together with other WPs, the treatment effect of interventions based on lifestyle modification to prevent and control chronic health conditions (cancer, cardiovascular diseases, depression, etc) will also be evaluated.
Coordinator: Luis García Ortiz (CyL)
Current Groups 
Castilla y León, BIPS, GrenSSAP, PREVAF-Cuenca, Baleares
Main projects
PVS
SEDESTACTIV
TABATIC
EVIDENT
EFICAR
EVIDENT II
Platforms 
Network of exercise research laboratories  

WP 2 CV. Evaluation of interventions for risk reduction and cardiovascular prevention 

The objective is to evaluate interventions (both pharmacological and behaviour modifications) directed at the reduction of cardiovascular risk in various target populations. Another objective is the evaluation and management of cardiovascular diseases in the population using estimation and mathematical modelling of risk, taking into account the holistic and longitudinal perspective of primary care.
Coordinator: Rafael Ramos (CardioCat)
Current Groups 
Cardiocat, Castilla y León, Baleares, Galicia
Main Projects 
5 projects that evaluate the cost-effectiviness of statins treatment in various target populations based on the SIDIAP platform: MARIA, EPREV, 4E, ECERC, PETREA.
TAHPS
MARK
FRESCO
Platforms 
RISCCAT

WP 3 Can. Adequacy of cancer detection activities 

The objective is to establish the coverage and degree of adequacy of cancer detection activities (populational or opportunistic) in primary care and to evaluate the effect of early diagnosis and the intensity of the follow-up in colorectal cancer patients. The effect of lifestyle-based promotion interventions in patients with cancer will also be evaluated, and the adherence to healthy lifestyles in cancer survivors patients.

Coordinator: Joan Llobera (Baleares)
Current Groups 
Baleares, GRenSSAP, Aragón, Galicia, BIPS
Main Projects
DECCIRE
EFICANCER
Platforms 
DECCIRE

WP 4 MH. Prevention of mental health disorders in primary care adult patients

The main objective is to develop and evaluate innovative interventions (effectiveness and efficiency) to prevent the onset, relapse and recurrence of anxiety and depressive disorders in adult primary care patients. Furthermore, predictive risk algorithms and on-line psychotherapy programs related to anxiety and depressive disorders will be developed.
Coordinator: Juan Bellón (Samserap)
Current Groups 
Samserap, Sant Joan de Déu, SM-Baleares, Aragón
Main Projects
PREDICT
PREDICT-CCRT
PREDICT-EVAL
ON-LINE PSYCHOTHERAPY STUDY
Platforms 
PREDICT

WP 5 HSR. Health Services Research related to preventive services in primary care

The main objective is to study the current situation of preventive activities (at the individual, group and community level), their variability and related factors, and their efficiency. The efficiency of the new proposed interventions and adherence to established guidelines and treatments will also be assessed. New instruments for data analysis (case-mix systems, classification of multimorbidities, etc) and feed-back using the electronic medical record will also be developed to improve the management of preventive activities in primary care.
Coordinator: Bonaventura Bolíbar (GRenSSAP)
Current Groups 
GRenSSAP, Baleares, Aragón, Sant Joan de Déu, Galicia, Cardiocat, Samserap
Main Projects
HYPOLIPIDAEMIA STUDY
REGIPREV
SMOKING AND PUBLIC LAW 
BENZOS STUDY
PRODEFAR
FIBROQUOL
Platforms 
REGIPREV
SIDIAP

WP 6 CT. Multi-risk clinical trial 

Design and implement a clinical trial following the methodology proposed by the MRC to evaluate the effectiveness and cost-benefit of a multi-factorial and multi-risk intervention for health promotion and disease prevention to reduce the most frequent chronic health conditions and favour active, healthy aging.

Develop the first 4 phases established by the Medical research Council (MRC)

  • Preparatory Phase (0). Preclinical/Theoretical: 1.- Conduct literature review and synthesize the available scientific evidence; 2.- Identify and evaluate the different health promotion theories as well as economic evaluation techniques and methods.
  • Phase 1. Modelling and operationalizing: 1.- Identify barriers and the elements that can facilitate the intervention. 2.- Determine the components of the intervention, their interrelationships and their relationship with health outcomes. 3.- Operationalize and adapt the intervention to the study centres.
  • Phase 2. Pilot test /exploratory trial: Implementation and feasibility study, determining acceptance and the potential effectiveness of the intervention.
  • Phase 3. Definitive clinical trial: Conduct the clinical trial, implementing an intervention that is appropriate, feasible and reproducible, with an appropriate control group and sufficient statistical power to verify the results.

Coordinator: Bonaventura Bolíbar (GRenSSAP)
Current Groups 
All groups

WP 7 I+D. Innovation and transfer

Develop and integrate new decision support tools for primary care professionals as well as interventions based on the use of ICT directed toward health promotion, prevention of chronic health conditions and their transfer to the private sector.
The actions in this WP are intended to enhance the network’s culture of innovation and stimulate the creation of innovative products. Therefore, it will focus on all of the products of innovation as they are produced by the network.
Coordinator: Javier García Campayo (Aragón)
Current Groups  
All groups