Table 3 GPs’ perceived barriers and facilitators for collaborating and reporting
Behavioral domains | Behavior area 1: Collaborating in cross-sectoral antenatal care (ANC) and social services (SS) | Behavior area 2: Reporting to social services (SS) | ||
|---|---|---|---|---|
TDF domains | Barriers | Facilitators | Barriers | Facilitators |
Theme I: Collaborative experience | ||||
a. Knowledge | Uncertainty of content of collaborative pathways in ANC | Knowing the working contexts of collaborative partners in ANC and SS | Lacking knowledge of the rationale behind individual responsibility to report | |
b. Skills | Lacking experience in navigating ANC and SS system | Lacking trained skills and routine in reporting on vulnerable pregnant women | ||
c. Memory, attention and decision processes | Lacking attention to the benefit of collaborating with ANC and SS professionals | Remembering to collaborate with other ANC and SS professionals | Cognitive limitations, delegating the decision of reporting to other HCPs | Being attentive to the individual responsibility to report |
d. Behavioral regulations | Efforts to arrange local education on collaboration in the ANC and SS system | |||
Theme II: Motivation | ||||
e. Social/professional role and identity | Judged meaningful tasks for GPs | Ethical dilemmas, managing the interests of both the unborn child and the pregnant woman | Keeping the professional obligations in mind | |
f. Beliefs about capability | Low professional confidence navigating in ANC for women with vague indicators of vulnerability | Having confidence in collaborating with vulnerable pregnant women due to existing doctor-patient relation | Low confidence in judging the need for a social report in vulnerable pregnant women | Having confidence in judging the need for reporting obvious threats to the fetus Having a strong doctor-patient relationship |
g. Beliefs about consequences | Feeling the loss of control when referring to social workers i.n SS | Fear of breaking the doctor-patient alliance | ||
h. Optimism | Pessimism: perceiving that a social report will have no consequence | Optimism: having positive experiences of the consequences of collaborating with SS | ||
i. Reinforcement | Remuneration for meetings with municipal social workers and health visitors in SS | |||
j. Goal | Not prioritizing time for collaboration on vulnerable pregnant women | |||
k. Intention | No coding | |||
l. Emotion | ||||
Theme III: Organizational working conditions | ||||
m. Environmental context and resources | Lacking clear and easy communication pathways across sectors Big social services organizations limit collaboration No information on initiatives of social support from SS | Minor size social service organ eases the cross-sectoral collaboration Face-to-face meetings with social workers regarding vulnerable pregnant women | Lacking two-way correspondence systems Lacking feedback from SS on the consequences of a social report | |
n. Social influences | Dissatisfacting experiences of collaboration lead to a lack of trust in SS | Perceiving positive values of collaborative partners in ANC | Social pressure from SS or other ANC partners to report | Patients wishing for social support |