Background

 

redIAPP 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  involved, 17 network projects, 57 papers, 10 doctoral theses, 12 short stays for training, more 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.

 

Research Programme

redIAPP has established a unique Research Programme:

Prevention and health promotion to carry out innovative interventions in Primary Health Care with the goal of avoiding the most frequent chronic diseases and favouring active, healthy ageing in the population.

Encouraging behaviours that contribute to a healthy lifestyles, such as participation in screening programs and adherence to drug treatment recommendations represent a key element in current health care systems, with the objectives of reducing the risk of disease and disability, contributing to active and healthy aging.

 

  • EV

    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  link azul
    Network of exercise research laboratories 


  • 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  link azul
    RISCCAT
  • adn genoma humano

    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  link azul
    DECCIRE
  • mente-cerebro

    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  link azul
    PREDICT
  • Clinical Audit

    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  link azul
    REGIPREV
    SIDIAP

  • Grupo

    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

  • ID

    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

Activities, Outputs and Outcomes of the Research Programme

OBJETIVESWPACTIVITIESOUTPUTSOUTCOMES
Evaluate disease prevention and health promotion activities that exists in primary health care and develop innovative new preventive interventions. WP1: LS
  • Finalize active projects
  • Propose and develop new ideas and projects
  • Construction of an inventory of unit costs for health care services
  • Data cleaning of the network's platform
  • Design of innovative intervention programmes for health promotion and prevention
  • Publications in high-impact journals
    Reports with recommendations directed at the various actors
  • Development and improvement of CPG
  • Participation in national and int. commissions
  • Inventory of unit costs
  • Maintenance and consolidation of network's platforms
  • Doctoral dissertations

  • Knowledge to design and implement innovative primary and secondary prevention programmes in PC
  • Increase patient empowerment and adherence to treatments and advice
  • To provide new evidences to clinicians and decision- and policy-makers to take better decisions and contribute to the sustainability of the national
    health system
  • Improvement in healthy habits, decrease in cardiovascular risk and risk in depression, lower incidence of major cardiovascular events, cancer, depression and anxiety
  • Transfer of the tools developed
  • Obtain complementary funding for the network programme
WP2: CV
WP3: CA
WP4: MH
WP5: HRS
Design and implement a clinical trial to evaluate the effectiveness and cost-utility of a multi-factorial and multi-risk intervention. WP6:Multirisk Trial
  • Phase 0: preclinical/ Theorical
  • Phase 1: Modelling and operationalizing
  • Phase 2: Pilot test /exploratory trial
  • Phase 3: Definitive clinical trial
  • Systematic review of the effectiveness and efficiency
  • Review of the health promotion theories and economic assessment methods
  • Validation of the multii-risk intervention
  • Publication in high-impact journals
  • Development of decision support tools
Develop and integrate new decision support tools, as well as interventions based on information and communications technology (ICT) and directed at the prevention of chronic diseases and technology transfer. WP7: I+D+i
  • Training in process of innovation and intellectually propriety
  • Support of the VHIR and search of private firms
  • ICT services orientation, utilization and integration
  • Development and validation of applications and tools
  • Development of secondary prevention new models based on ICT
  • Validation of questionnaires
  • Development and validation of instruments applicable to information management
  • Agreements or contracts with private enterprise

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