Health promotion and older people: a qualitative study of general practitioners' views

Objectives: To explore general practitioners' (GPs') beliefs about health promotion for older people and attitudes towards educational strategies likely to improve practice in this area. Design and setting: Four discussion groups, each lasting one and a half hours, completed in Melbourne, Australia in August and September 1995. Interviews were transcribed verbatim and analysed for major themes. Participants: A convenience sample of 20 GPs took part; 11 university affiliates, four participant contacts and five GPs from telephone book listings. Results: GPs' perceptions of their health promotion practice varied from ''integrated into all medical care'', to ''something separate from usual practice''. Positive views of older people contrasted with ageist views, with a few GPs expressing a nihilistic approach to medical care of older people. Regardless of the GPs' attitudes, lack of time and reimbursement disincentives were perceived to limit preventive practice and the potential impact of health promotion interventions. GPs felt overwhelmed with their workloads, and initial reactions to the idea of any ''new'' program were negative. Reactions to educational strategies varied, with choice and relevance to ease of practice being important for GP participation. Conclusions: GPs differ in their views of health promotion and in their approaches to its delivery for older people. Educational programs are often viewed negatively, but if they offer the opportunity to save time, increased participation may be more likely.