Five Years after Implementation of Urban Family Physician Program in Fars Province of Iran: Are People’s Knowledge and Practice Satisfactory?

Behnam Honarvar, Kamran Bagheri Lankarani, Maryam Kazemi, Fatemeh Shaygani, Eghbal Sekhavati, Atefeh Raoouf, Hadi Raeisi Shahraki

Abstract


Introduction: Urban family physician program (UFPP) was launched in Fars province of Iran in 2012. We aimed to assess the knowledge and practice of people toward this 5‑year‑old program.

Methods: In this population‑based study, through a multistage random sampling from 6 cities of Fars province, 1350 people older than 18 years were interviewed. For data collection, a questionnaire consisting of sociodemographic characteristics and items about knowledge and
practice toward UFPP was used.

Results: The mean age of the interviewees was 42.4 ± 14.2 years; male (674; 49.9%)‑to‑female (651; 48.2%) ratio was 1.03. Mean score of knowledge was 4.2 ± 1.7 (out of 14), while 961 (71.1%) had <50% of the desirable knowledge. Mean score
of practice was 4.4 ± 1.3 (out of 9), while only 443 (32.8%) had a good performance toward this program. Knowledge and practice did not show a signifcant correlation (r = 0.06, P = 0.05). Among cities, the highest and the lowest mean of knowledge belonged to Pasargad (5.6 ± 2.1)
and Lar (3.0 ± 1.0) (P < 0.001), respectively. Pasargad (4.8 ± 1.4) had also the highest level of practice compared to Farashband (3.8 ± 1.4) which had the lowest score (P < 0.001). Multivariable analysis showed that supplemental insurance coverage (odds ratio [OR] = 2.5, %95 confdence
interval [CI]: 1.6–3.9), female gender (OR = 1.9, %95 CI: 1.2–2.9) and higher level of education (OR = 1.7, %95 CI: 1.1–2.5) were the signifcant determinants of knowledge, while practice in those who were not covered by supplemental insurance was better (OR = 1.6, 95% CI: 1.2‑2.5).

Conclusions: After 5 years of implementation of UFPP, knowledge and practice of people toward UFPP are not satisfactory. This fnding calls for a serious revision in some aspects of UFFP.

Keywords: Family physician program, knowledge, practice, urban population


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References


The European Definition of General Practice Family Medicine

Wonca Europe 2011 edition. Available from: http://www.

woncaeuropeorg/sites/default/files/documents/Definition%20

rd%20ed%202011%20with%20revised%20wonca%20treepdf.

[Last accessed on 2017 Apr 23].

World Organization of Family Doctors. WONCA in Brief;

Available from: http://www.globalfamilydoctor.com/

AboutWonca/briefaspx. [Last accessed on 2017 Apr 23].

American Academy of Family Physicians. Definition of Family

Physician; 2017. Available from: http://www.aafp.org/about/

policies/all/family‑medicine‑definitionhtml. [Last accessed on

Apr 23].

World Organization of Family Doctors. WONCA Annual

Report July 2015‑June 2016; 2004. Available from: http://www.

globalfamilydoctor.com/AboutWonca/Annualreportaspx. [Last

accessed on 2017 Apr 23].

Honarvar B, Lankarani KB, Ghahramani S, Akbari M, Tabrizi R,

Bagheri Z, et al. Satisfaction and dissatisfaction toward urban

family physician program: A Population based study in Shiraz,

Southern Iran. Int J Prev Med 2016;7:3.

Kor EM, Rashidian A, Hosseini M, Azar FE, Arab M.

Acceptability of the urban family medicine project among

physicians: A Cross‑sectional study of medical offices, Iran.

Glob J Health Sci 2016;8:56295.

Islamic Parliament of Iran. Law of the Fifth Economic, Social

and Cultural Development Plan of the Islamic Republic of Iran,

‑2015 (1389‑1394). Available from: http://www.rcmajlisir/

fa/law/show/790196. [Last accessed on 2017 Apr 23].

Saber AA, Jafar‑Sadegh T, Mohammad M, Mohammad NB,

Amin D, Mohammad S. Nine years of publications on strengths

and weaknesses of family physician program in rural area of

Iran: A systematic review. J Anal Res Clin Med 2016;4:182‑95.

Motlagh ME, Nasrolahpour SS, Ashrafian AH, Kabir MJ,

Shabestani MA, Nahvijoui A, et al. Familiarity of rural people

engaged in rural assurance towards principles, facilities, and

conditions of rural assurance in family physician (FP) program

in northern provinces of Iran‑2008. J North Khorasan Univ Med

Sci 2010;2:33‑8.

Alidosti M, Tavassoli E, Khadivi R, Sharifirad GR. A survey

on knowledge and attitudes of rural population towards the

family physician program in Shahr‑e‑kord. Health Inform Manag

;7:629‑36.

Honarvar B, Lankarani KB, Rostami S, Honarvar F, Akbarzadeh A,

Odoomi N, et al. Knowledge and practice of people toward their

rights in urban family physician program: A population‑based

study in Shiraz, Southern Iran. Int J Prev Med 2015;6:46.

Haines A, Kuruvilla S, Borchert M. Bridging the implementation

gap between knowledge and action for health. Bull World Health

Organ 2004;82:724‑31.

Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T,

Hayes S, et al. Gaps between knowing and doing: Understanding

and assessing the barriers to optimal health care. J Contin Educ

Health Prof 2007;27:94‑102.