Arwa Nasser Al Zahrani

Introduction: Saudi Ministry of Health (MOH) is starting to transfer the delivery of primary health care (PHC) services from solo practice to team-based care (TBC) model. It is an important to understand factors that affect the integration of this new model of care in the early stage of implementation process to ensure adequate incorporation of this new intervention into the routine work in PHC centers. Normalization process theory (NPT) is a method that helps evaluate the integration of new interventions. Therefore, this study aimed to explain the integration of TBC model in PHC services and investigate the barriers that may hinder the implementation of this model through using NPT. Methods: A cross-sectional study was conducted in PHC centers of Saudi MOH 7 months after the implementation of TBC model. A systematic random sample technique was used to select participants from all Saudi regions. A NPT questionnaire was sent online to the participants to collect data. Results: The study revealed that cognitive participation construct represented the highest score (4.06 ± 0.74) followed by coherence (3.78 ± 0.87) and reflexive monitoring (3.75 ± 0.79) constructs. Collective action construct represented the lowest integration score (3.48 ± 0.68). Gender, years of work experience, and duration of applying TBC model were not significant factors affecting the mean integration scores of the four constructs of NPT. Conclusion: The study recorded good integration scores of the included health staff to TBC model. However, the study demonstrated some barriers that may hinder the implementation progress of the model including inadequate staff training, insufficient resources, and lack of feedback reports. Other recorded barriers are the staff perception that TBC model affects the nature of their work and disrupts the working relationship. Sufficient resources, adequate staff training with close supervision, and providing them with feedback reports regularly are recommended to support and improve the implementation of the TBC model in PHC services.

Road traffic crashes represent a substantial global public health issue. In Saudi Arabia, which is the focus area of this research, road traffic crashes kill over 130,000 people annually, accounting for almost 5% of deaths in that country. A cross-sectional study with 316 participants holding a valid Saudi driver’s license was conducted via the internet from December 2019 to March 2020 to collect information about the prevalence of risky driving habits among Saudi drivers. The sample was predominantly men and aged between 20 and 39, which is representative of the population of drivers in Saudi Arabia. Drivers generally reported engaging in safe behaviors, although they did state that they drove above the legal speed limit, drove aggressively around slow drivers, and became distracted while driving with some frequency. Multivariate analyses suggested men took more risks than women and younger drivers took more risks than older ones. We conclude that the behavior among drivers in Saudi Arabia generally matches those in other cultures and countries, with men and young adults taking the most risks while driving. Preventative strategies should be developed and implemented in Saudi Arabia.