Exploring Healthcare Providers' Experiences: Barriers and Facilitators to Health-Promoting Behaviors in COVID-19 Patients

Abstract

Background: The COVID-19 pandemic posed unprecedented challenges to healthcare systems worldwide, particularly in promoting health behaviors among patients. Understanding healthcare providers' experiences in addressing barriers and facilitators is critical to improving pandemic response strategies. Objectives: This study explored healthcare providers’ perspectives on barriers and facilitators of health-promoting behaviors among patients with COVID-19. Methods: This qualitative study used conventional content analysis. Data were collected through semi-structured interviews with 12 participants, including physicians, nurses, laboratory technicians, psychiatrists, midwives, health workers (Behvarz), and emergency medical specialists in the healthcare system in Kermanshah, Iran. Participants were selected using purposive sampling, and recruitment continued until data saturation was reached. Interview data were analyzed to identify emerging themes and patterns according to established content analysis protocols to ensure rigor and validity. Results: In the barrier analysis, 63 initial codes were confirmed and organized into 11 subcategories and four main categories. For facilitators, 49 initial codes were identified and classified into nine subcategories and five main categories. Barriers to health-promoting behaviors among patients with COVID-19 included structural and systemic barriers, individual and psychological barriers, cultural and informational barriers, and awareness and knowledge barriers. Facilitators included public health education and communication, government-led policies and equity measures, community engagement and resilience building, healthcare system strengthening and prevention, and vaccination and immunization efforts. Conclusions: In Iran, particularly in the Kermanshah region, substantial structural barriers, including resource shortages and economic challenges, together with strong cultural beliefs and widespread misinformation, created distinct obstacles to promoting health behaviors during the COVID-19 pandemic. Therefore, effective interventions require simultaneous efforts to strengthen the health infrastructure, implement targeted and culturally tailored educational campaigns, and engage trusted social and religious community leaders. By addressing these challenges and leveraging facilitators, healthcare systems can better respond to future pandemics and improve patient outcomes.