Background
Primary care is at the frontline of meeting the increasing demand for care and support for people with complex and long-term care needs. The fact that the health system has mainly been organised upon a disease and problem-oriented approach, puts these people at risk of fragmented care. One of the suggested strategies to optimize the integration and collaboration in care delivery is goal-oriented care (GOC) which explicitly focusses on patients’ personal goals. Current research indicated that primary care providers (PCPs) believe that GOC could support their work and that they are willing to adopt GOC in practice. At the same time, they express a need for more training. This need for training is consistent with experiences of patients indicating that GOC isn’t clearly part of their encounters with healthcare providers. These findings indicate a gap between PCPs’ beliefs on the importance of GOC on the one hand, and the GOC-behaviour they can demonstrate in practice on the other hand. Therefore, specific research on competencies and skills required for providing GOC is needed in order to support PCPs to implement GOC in their daily practice.

Overall aim
This dissertation develops a practice-based foundation for competencies that support Goal-Oriented Care (GOC) in primary care.

Context
The research was conducted in the context of a preliminary interprofessional GOC training organized for 60 primary care providers (PCPs) from multiple disciplines. Several studies drew on this trained cohort and its implementation experiences in practice.

Research questions & respective methods
RQ 1: “'How do PCPs experience the behaviour change process when implementing GOC in their practice six months after participating in an interprofessional training on GOC?'
A qualitative generic approach combined a deductive focus on behaviour change using the Capability-Opportunity-Motivation-Behaviour (COM-B) model, with an inductive exploration of PCPs' lived experiences. Five Primary Care Zone-based focus groups were conducted with 22 PCPs and analysed thematically following Braun and Clarke.

RQ 2: “What behaviour do PCPs show when providing GOC in their practice?”
A focused, team-based ethnographic approach combined non-participant observations with short reflective interviews. PCPs were purposively sampled from a cohort who completed interprofessional GOC training. Data were analysed using thematic analysis.

RQ3: “Which PCP competencies contribute to patients experiencing GOC?”
A qualitative dyadic design, informed by interpretative phenomenological analysis (IPA), explored patient experiences of GOC within an ongoing relationship with a PCP, and the provider competencies perceived as enabling these experiences. Patient-provider dyads were recruited via trained PCPs. Within each dyad, separate semi structured interviews were held with patients and providers.

RQ 4: “How does interprofessional GOC-training affect PCPs’ attitudes towards interprofessional collaboration?”
A convergent mixed-methods design combined Primary Care Zone-based focus groups six months post-training with pre–post measurement using the Interprofessional Socialization and Valuing Scale to examine changes in beliefs, attitudes and behaviours related to interprofessional collaboration.