Cocreating Actions to Improve Rationality in the health system

Introduction

Despite widespread recognition of social, economic, or environmental health determinants, health action remains heavily dominated by individual-level solutions (e.g., medication, patient counselling, vaccination). This proposal aims to stimulate changes in health system functioning by demonstrating how the cocreation of actions to address psychological well-being, cardiovascular health, and antimicrobial resistance from within the community can alleviate the burden on primary care services, reduce medicalisation, and increase health equity.

Scientific Approach

The scientific approach uses mixed methods and incorporates theory from multiple disciplines. We will appraise how the current system addresses:

1. Psychological well-being
2. Cardiovascular health
3. Rational use of antibiotics

This will be achieved through various methods, including:

• A population survey
• A survey of patients collecting their medication at community pharmacies
• Aggregate health service indicators on medication consumption and primary care consultations
• Qualitative methods exploring stakeholders’ perceptions

Community Engagement

We will undertake community-based participatory research to engage citizen scientists in the cocreation of community-led actions to promote psychological well-being, cardiovascular health, and prevent antimicrobial resistance.

Action Design and Evaluation

The design, implementation, and evaluation of the actions will apply an assets-based approach and utilize theories and frameworks from implementation science in an iterative manner over 3 years.

Impact Analysis

Finally, we will analyse the impact of the cocreated actions, considering effectiveness and broader contextual issues such as initiative adoption, implementation, and maintenance. This will involve:

• A before-after comparison of survey indicators
• An interrupted time-series analysis of health service data
• Qualitative analysis

Conclusion

The goal is to demonstrate how the integration of community action with attention to the social determinants of health can lead to a more rational approach to health care and ultimately improve health and health equity.