Formative assessment of best practices in primary care: early CIRCE-JA findings

Background

The CIRCE-JA, co-funded by HaDEA, aims to transfer and implement evidence-based best practices (BPs) to strengthen primary health care (PHC) systems across Europe. Formative assessment was used to monitor early implementation, extract preliminary findings, and inform continuous adaptation.

Methods

A mixed-methods approach was applied, using data from implementation plans, structured questionnaires, and monitoring activities across 40 EU sites. The assessment was guided by predefined metrics (reach, acceptability, adoption, appropriateness) based on the RE-AIM framework and the taxonomy proposed by Proctor et. al. (2010). Data from multidisciplinary teams implementing BPs in diverse PHC settings were analyzed using descriptive statistics and qualitative synthesis to assess early progress and contextual factors.

Results

Early findings indicate satisfactory reach, with engagement of multidisciplinary teams and diverse target populations. Adoption was initiated through training, care pathway development, screening and prevention activities. High acceptability was reported among healthcare professionals, particularly for integrated, patient-centered approaches. Appropriateness was confirmed across settings, reflecting alignment with local PHC needs. However, the adoption variability observed is attributed to differences in organizational readiness and resources. Key barriers included limited digital infrastructure, workforce constraints, and challenges in maintaining stakeholder engagement.

Conclusions

Formative assessment demonstrates early progress in BP implementation across heterogeneous PHC settings while identifying key implementation barriers and facilitators. These findings support adaptive implementation and inform subsequent evaluation of effectiveness and impact.

Key messages

• Standardized metrics enable consistent formative evaluation across health systems.

• Early findings show promising uptake of BPs alongside structural implementation barriers.