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The project will be positioned in the division Quality of Primary Care of the Centre for Quality of Care

Research (WOK) of the Universities of Nijmegen and Maastricht. This Centre is part of the by the KNAW

aknowledged research school CaRe, a collaboration of ExTRa and Health UM, NIVEL, EMGO-VU,

University medical Centre-KUN). The expertise from several lines of research in the Centre can

deliver input in this project:

- evaluation of national primary care programs. Large controlled experiments and evaluation studies

have been undertaken to evaluate the national implementation of organisational and educational

activities to improve the quality of preventive care in general practice. Topics: prevention of

cardiovascular diseases (HAPP-project), screening procedures for cervical cancer, diffusion and

implementation of flu-vaccination procedures, the integration of nurse practitioners in primary care.

At the moment studies are perfomed to evaluate the impact of a nationally co-ordinated stimulation

program for mental health care in general practice. Well-structured proces analyses are part of most

the research projects mentioned above.

- evaluation of smoking cessation protocols in the context of chronic disease management.

In some of the preventive protocols mentioned above the integration of smoking cessation treatment

in primary care was an integral part of the intervention. Some large controlled trials specifically aimed

at testing the effectiveness of cessation counseling protocols (SMOCC, in collaboration with the

Department of Health Prevention and Promotion of Maastricht University) are in a final stage.

- meta-analysis of quality assessment and quality improvement methods and their efficiency and

efficacy. In recent years a lot of quality implementation procedures have been tested. E.g. within the

context of EQuiP (the European Working Party on Quality in Family practice) projects in more than 20

countries haven been evaluated. The research results of a national guideline implementation

program for primary and secundary care funded by the Ministry of Health, contribute to the body of

knowledge on effectiveness of implementation methods. Recently the Centre produced an inventory

of effectiveness of different types of quality improvement interventions in health care (Grol, Wensing

et al., 2001).

- expertise about qualitative research has been accumulated by projects around patient

empowerment, care for seriously ill patients (Palliative care, Alzheimer disease), resulting in regular

courses for qualitative research in the context of teh research school.

The Centre has close working relations with several national and international organisations of health

care and health care research. Within the context of the project the Centre participates in a research

collaboration containing researchers and institutes interested in smoking cessation research. (e.g.


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