Health-care climate, perceived self-care competence, and glycemic control among patients with type 2 diabetes in primary care.

This study showed, in line with self-determination theory, that glycemic control among patients with type 2 diabetes ( = 2866) was strongly associated with perceived self-care competence, which in turn was associated with autonomous motivation and autonomy-supportive health-care climate. These associations remained after adjusting for the effect of important life-context factors. Autonomous motivation partially mediated the effect of health-care climate on perceived competence, which fully mediated the effect of autonomous motivation on glycemic control.

Determinants of effective health promotion actions in local contexts: a study of the perceptions of municipal politicians.

Objective: To compare municipal politicians' perceptions of health promotion policy and its impact, and whether these perceptions varied according to political variables.

Methods: A mail survey to all municipal politicians (N=195) in four municipalities in Finland. Response rate was 52%.

Does patients' choice of health centre doctor depend on the organization? A comparative study of four municipalities with different forms of service provision in Finland.

Aims: The aim of the study was to examine the use of physician services and the willingness to choose an health centre (HC) doctor rather than an alternative (i.e. private, occupational healthcare, other doctor) by the working age population in four municipalities in Finland.

Job involvement of primary healthcare employees: does a service provision model play a role?

Aim: To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated.

Methods: A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%).

Psychosocial work environment and emotional exhaustion--does a service provision model play a role?

Objectives: To investigate whether outsourcing of primary health care (PHC) services has affected the psychosocial work environment and emotional exhaustion.

Methods: Panel mail study 2000-2002 in Finland, 369 PHC employees. Comparison between Southern municipality (SM) after outsourcing PHC services to a not-for-profit organization and three municipalities with municipal service providers.

Determinants of health promotion action in primary health care: comparative study of health and home care personnel in four municipalities in Finland.

Aims: The purpose of this paper is to contribute to understanding which factors influence health promotion action in primary health care (PHC) on the municipal, i.e. local, level.

Outsourcing primary health care services--how politicians explain the grounds for their decisions.

Objective: To explore outsourcing of primary health care (PHC) services in four municipalities in Finland with varying amounts and types of outsourcing: a Southern municipality (SM) which contracted all PHC services to a not-for-profit voluntary organization, and Eastern (EM), South-Western (SWM) and Western (WM) municipalities which had contracted out only a few services to profit or public organizations.

Methods: A mail survey to all municipality politicians (response rate 52%, N=101) in 2004. Data were analyzed using cross-tabulations, Spearman correlation and linear regression analyses.

Client perceptions of the performance of public and independent not-for-profit primary healthcare.

Aims: To compare primary healthcare (PHC) provided by an independent not-for-profit organization (INPO) with that provided by two public municipal organizations (MO1 and MO2), in terms of clients' perceptions of performance, acceptance, and trust.

Methods: A survey using a pre-tested questionnaire to all clients visiting a health centre (HC) doctor or nurse during one week in 2000 (n = 511, 51% response rate) and 2002 (n = 275, 47%). The data were analysed by descriptive statistics and cumulative logistic regression analysis.

Determinants of health promotion action: comparative analysis of local voluntary associations in four municipalities in Finland.

The World Health Organization makes a case for the importance of voluntary organizations in promoting health at local levels. The purpose of this paper is to contribute to understanding which factors explain local voluntary associations (LVAs) participation in health promotion in local contexts. It does so through (i) identifying indicators that represent determinants of health promotion action which were reported by LVAs and by (ii) comparing their actions with these determinants.