Non-communicable diseases such as diabetes, hypertension, and cardiovascular disease are leading contributors to morbidity and mortality and increase demands on primary care. Effective health promotion and disease prevention (HPDP) strategies—including screening, health education, and lifestyle counselling—are central to reducing disease burden and healthcare costs. Community pharmacists (CPs) are accessible healthcare professionals who can expand beyond dispensing roles to deliver HPDP services, particularly in low- and middle-income settings. However, integration of HPDP into routine pharmacy practice is challenged by time constraints, limited training, IT infrastructure gaps, and variable professional experience.
The study aimed to explore CPs’ perceptions and experiences of providing HPDP services in Jordan and to identify factors influencing service delivery, including facilitators and barriers. The authors used a theoretically informed lens, mapping emergent themes to the Capability, Opportunity, Motivation-Behavior (COM-B) framework to interpret influences on pharmacists’ professional behavior.
This qualitative study employed face-to-face semi-structured interviews conducted in Amman, Jordan. Data collection took place between January and April 2025. Interviews were audio-recorded and transcribed verbatim for analysis.
Participants were community pharmacists recruited through purposive and snowball sampling. Fifteen pharmacists took part in the study. The manuscript reports that data collection and analysis were conducted concurrently and that data saturation was reached when no new themes emerged.
Transcribed interviews were analyzed using inductive thematic analysis following Braun and Clarke’s six-step approach. Analysis was performed in NVivo QSR 14. Two researchers independently coded the transcripts to enhance analytic rigor. After inductive theme generation, identified themes were deductively mapped to the COM-B framework to situate findings within a behavior-change model.
Participants described a range of evolving roles for CPs in HPDP. Reported activities included health education, lifestyle counselling, screening-related tasks, and participation in public health initiatives such as vaccination programs and telepharmacy services. Pharmacists perceived their role as increasingly extending into preventive care in response to rising chronic disease prevalence, aging populations, and greater public awareness of health risks.
Pharmacists identified several barriers limiting their ability to deliver HPDP services. Major constraints included heavy workload and competing dispensing responsibilities, limited patient engagement or interest in preventive services, lack of appreciation and support from pharmacy owners, and absence of financial incentives for preventive activities. Structural and systemic challenges—such as insufficient infrastructure and integration with other healthcare services—were also reported as impediments.
Participants highlighted needs for enhanced professional development and capacity building. Continuing professional development, improvements in undergraduate training to better prepare graduates for HPDP roles, and strengthened collaboration with physicians were cited as facilitators that could expand pharmacists’ contribution to prevention and health promotion. The study noted prior evidence of training and infrastructure gaps among Jordanian CPs, reinforcing the need for targeted educational interventions.
Pharmacists reported that providing HPDP services yields benefits for patients, pharmacists, and the broader healthcare system. Benefits described included improved patient health literacy and outcomes, enhanced professional satisfaction for pharmacists, and potential system-level gains such as reduced healthcare burden and costs. Despite these positive impacts, the reported barriers limited the scale and consistency of HPDP delivery in routine practice.
Deductive mapping of themes to the COM-B framework indicated that engagement in HPDP is influenced by: capability-related factors (knowledge, skills, training), opportunity-related factors (workload, infrastructure, business models, interprofessional relationships), and motivation-related factors (recognition, incentives, professional identity). The authors used this mapping to demonstrate that multi-level interventions—addressing capability, opportunity, and motivation—are needed to support sustained behavior change among CPs.
The study concludes that community pharmacists in Jordan are active contributors to HPDP but face structural, educational, and motivational barriers that limit their full participation. Recommended actions include targeted training and capacity building, infrastructure development within pharmacies, enhanced pharmacist–physician collaboration, and public awareness initiatives to increase acceptance of pharmacist-led preventive services. These measures are presented as essential to strengthen pharmacist-led HPDP services and to integrate CPs more fully into public health strategies in Jordan.
(Study funding and publication): The research was funded by Al-Zaytoonah University of Jordan. The article is published in PLOS ONE (published August 5, 2026).