Grounded Theory Study Maps How Primary Healthcare Managers Use Evidence in Decisions

Researchers have developed a conceptual framework explaining how primary healthcare managers make evidence-based decisions, drawing on qualitative interviews with managers, experts, and specialists. The study, published in BMC Primary Care, used Strauss and Corbin’s grounded theory approach to build a model of the factors that shape whether organizational decisions in primary healthcare rest on the best available evidence.

The team conducted semi-structured interviews with 17 participants selected through purposive and theoretical sampling. Data were analyzed using open, axial, and selective coding, the sequential procedures of grounded theory analysis, to identify relationships among categories and assemble them into a conceptual framework. Because the work is qualitative and based on a purposively sampled group of 17 participants, the framework is an explanatory model generated from these interviews rather than a statistically generalizable finding about all primary healthcare systems.

The analysis identified thirteen main categories, organized within six dimensions of grounded theory: causal conditions, contextual conditions, intervening conditions, the core phenomenon, strategies, and consequences. This structure reflects the grounded theory convention of explaining a phenomenon by situating it among its causes, the setting in which it occurs, obstacles and facilitators that intervene, the central process itself, the actions taken in response, and the outcomes that follow.

Substantively, the framework highlights interactions among several elements: the characteristics of evidence itself, the people who demand evidence and those who supply it, organizational structure and resources, legal requirements, organizational support, evidence utilization, training, and monitoring, together with the resulting organizational and community outcomes. In other words, whether a primary healthcare manager integrates research evidence into a decision is portrayed not as an individual act but as the product of an interlocking system, in which institutional capacity, legal mandates, supportive management practices, staff training, and monitoring mechanisms all condition how evidence moves from suppliers to decision-makers and into practice.

The authors state that the framework explains how organizational, contextual, and managerial factors interact to shape evidence-based decision-making among primary healthcare managers, and that it offers practical guidance for strengthening evidence-based management and policymaking within primary healthcare systems. As a grounded theory model built from interviews in a specific setting, its transferability to other health systems would need to be assessed against local conditions, and testing its practical value would require subsequent empirical work. The article was published open access on 27 October 2026 and is being shared early as a peer-reviewed, accepted version of record that remains subject to further edits.

Subject of Research: A grounded theory study developing a conceptual framework for evidence-based decision-making among primary healthcare managers

Article Title: Conceptual framework of evidence-based decision-making among primary healthcare managers: a grounded theory study

Article References: Hedayatipour, M., Etemadi, S., Rahimisadegh, R., & Noori Hekmat, S. (2026). Conceptual framework of evidence-based decision-making among primary healthcare managers: a grounded theory study. BMC Primary Care. https://doi.org/10.1186/s12875-026-03627-5

Image Credits: AI Generated

DOI: 10.1186/s12875-026-03627-5

Keywords: evidence-based decision-making, primary healthcare, grounded theory, healthcare management, qualitative research, conceptual framework, health policy, organizational factors, semi-structured interviews, BMC Primary Care, Conceptual, framework