Integrating rural community screening initiatives into general practice: a qualitative evaluation of the Care2U rural outreach pilot program

BACKGROUND: Diabetes and cardiovascular disease profoundly affect rural Australians. The Care2U program was proposed to integrate rural community-based screening with general practice systems. Its innovative feature is a closed-loop communication model between outreach teams and general practitioners (GPs), enabling systematic tracking of diagnoses, management and outcomes for screening-detected medical conditions. This study explored the acceptability, feasibility and sustainability of the proposed model from healthcare providers' perspectives. METHODS: A qualitative study was undertaken using a focus group. A total of 12 participants, including GPs, nurses, practice managers and health informatics professionals, took part in a 91-min discussion in April 2025. The proposed Care2U model, incorporating mobile outreach screening for diabetes and cardiovascular disease risk factors, was discussed. Transcripts were thematically analysed, with findings interpreted using the critical realism lens to account for structural, organisational and individual influences. RESULTS: Four overarching themes were identified: (i) strong perceived need and value of outreach services in underserved communities; (ii) strategies and challenges in identifying and engaging at-risk patients, particularly those without a regular GP; (iii) desired scope of screening, including both biomedical and lifestyle risk factors, with mixed views on feasibility of remote heart rhythm monitoring; and (iv) communication, workflow and medico-legal responsibilities in managing abnormal findings. Participants emphasised the need to integrate results directly into GP software and to establish clear responsibility for unaffiliated patients. CONCLUSIONS: The Care2U program was perceived as a valuable and feasible model to extend preventive care to rural communities. Its closed-loop communication system offers the potential to ensure continuity of care, strengthen GP-community integration and measure program impact. Addressing medico-legal, workflow, and sustainability challenges will be crucial for the implementation and scale-up of this initiative.