JMIR Publications

ABSTRACT

Background:

GPFirst is a primary care partnership programme designed to encourage patients with non-urgent conditions to seek care at participating general practitioner (GP) clinics before visiting the emergency department (ED). In 2019, a digital media campaign (DMC) was launched to raise awareness and knowledge about GPFirst among residents in eastern Singapore.

Objective:

To assess the DMC’s impact on awareness, knowledge of GPFirst across different age groups plus the acceptability and satisfaction of GPFirst among residents.

Methods:

The DMC consisted of Facebook posts and website which were designed with components of Andersen's behavioural model. Its impact was assessed through two repeated cross-sectional surveys. The first survey (CS1) was conducted with residents aged 21 and above of eastern Singapore two months before the campaign started, and the second survey (CS2) was conducted four months after the campaign commenced. Satisfaction was measured using a 5-point Likert scale (very poor to excellent) about the overall experience of GPFirst. Acceptability was assessed with three yes/no questions on participants’ decision to visit or recommend the GPFirst clinic to others. Analyses utilised tests of proportions and adjusted multivariable regression models. Age-stratified secondary analyses were also performed.

Results:

The Facebook posts in DMC generated 38,404 engagements within five months of DMC rollout with “#ThankYourGP” posts being most viewed (24,602) and engaged (2,618). Overall, 1191, and 1161 participants completed CS1 and CS2 respectively. Compared to CS1 participants, CS2 participants were more aware (OR = 2.64, p < 0.001) and knowledgeable of GPFirst (OR = 4.20, p < 0.001). GPFirst awareness was higher among married individuals (OR = 1.31, p = 0.026), those without a regular primary care physician (RPCP) (OR = 1.79, p < 0.001), and with higher education levels. Specifically, compared to individuals with primary-level education, those with secondary (OR = 2.12, p < 0.001), pre-university (OR = 2.17, p < 0.001), and university education or above (OR = 1.95, p = 0.002) were more likely to be GPFirst-aware. Similarly, knowledge of GPFirst was higher among individuals with secondary (OR = 2.88, p = 0.006) and pre-university education (OR = 2.56, p = 0.022), and those without an RPCP (OR = 1.54, p = 0.041). For acceptability, overall, 89.1% reported they would visit a GPFirst clinic before the ED in the future. Among participants who visited a GPFirst clinic, 95.2% would recommend the clinic to others, 60.2% reported that their choice to visit the clinic was influenced by its participation in GPFirst and 87.3% were satisfied with GPFirst.

Conclusions:

The DMC increased awareness and knowledge of GPFirst among the target residents. Results illustrated high population-wide acceptance of GPFirst and satisfaction among programme participants. Findings also highlighted the need to have age-dependent strategies to improve GPFirst participation among residents.