Action research: a useful method of promoting change in primary care?

Background. Action research has been used successfully to promote change in disciplines other than medicine, but there are few examples of its use in primary care. Objective. We aimed to discuss the benefits and difficulties of using actio n research in primary care using the example of child health surveillance p rovision in general practice. Methods. Twenty-eight general practices were randomly allocated into two gr oups. Action research was used to promote change in 14 practices by facilit ating practice meetings and by providing written feedback. The other 14 pra ctices received written feedback alone. The two groups of practices were co mpared using the following: (i) semi-structured interviews with one health visitor and GP from each practice; (ii) observation of baby clinics; (iii) questionnaires to parents; and (iv) return rates of child health surveillan ce reviews from the personal child health record. Results. All 14 practices in the action research arm of the study met as in dividual practice tea ms and decided to make changes to their provision of chi Id health su relevance. Ten practices audited their child health survei llance as a result. More health visitors in the action research practices t han in the comparison practices reported changes to child health surveillan ce, audit, communication and use of the personal child health record. The m ajority of health visitors and GPs thought involvement in the action resear ch process was beneficial. However, we were unable to show a statistically significant difference between the two groups of practices in baby clinic p rovision, parent satisfaction or the return rate of child health surveillan ce reviews. Conclusion. Our study suggests that action research is a successful method of promoting change in primary care. However, measuring the impact of chang e is difficult.