Unravelling the factors decisive to the implementation of EPODE-derived community approaches targeting childhood obesity: a longitudinal, multiple case study

Abstract Background Implementation of intersectoral community approaches often fails due to a translational gap between the approach as intended and the approach as implemented in practice. Knowledge about the implementation determinants of such approaches is needed to facilitate future implementation processes. Methods The implementation of five EPODE-derived intersectoral community approaches was studied longitudinally. Semi-structured interviews were held with 189 community stakeholders from four sectors to elucidate which determinants influenced implementation, and if an to which extent determinants differed across communities, sectors and over time. A framework approach was used to analyze our data. Results Twenty-two key determinants of implementation were identified. Facilitators named were mostly proximal (stakeholder level), and barriers were mostly distal (context level). Key determinants varied greatly across sectors and over time, especially between the educational & health care sector and the private, welfare & sports sector. Only ‘perceived importance of IACO goals’ was identified as an universal implementation facilitator. Conclusions Striking differences in determinants were found across sectors and over time. Also, stakeholders expressed that possibilities to adapt the approach to the local context were needed to improve implementation. We therefore propose to develop sector- and time specific leads for implementation, which should be approved and amended (over time) by stakeholders. This so-called ‘mutual adaptation’ allows for the use of both scientific insights and practice-based knowledge, enabling program management and community stakeholders to collaboratively improve their implementation efforts

Implementation of effective blended periconception lifestyle care in a tertiary hospital in the Netherlands:A cross-sectional study on determinants and patient satisfaction

OBJECTIVE: To identify implementation determinants of blended periconception lifestyle care, and to evaluate patient satisfaction. DESIGN: Cross-sectional study. SETTING: The outpatient clinic of the department of Obstetrics and Gynaecology of the Erasmus MC. PARTICIPANTS: Implementation part: counsellors providing blended periconception lifestyle care. Patient satisfaction part: women who received blended periconception lifestyle care. METHODS: Blended periconception lifestyle care, including face-to-face counselling and 26 weeks of lifestyle coaching via the online platform ‘Smarter Pregnancy’, was implemented between June–December 2018. The Measurement Instrument for Determinants of Innovations questionnaire was used as input for the consolidated framework for implementation research to assess determinants of implementation. To evaluate patient satisfaction, patients receiving lifestyle care filled out an evaluation questionnaire, including questions on the needs for lifestyle counselling, information provision during counselling, and motivation and lifestyle change after counselling. PRIMARY AND SECONDARY OUTCOME MEASURES: Identification of implementation determinants and the level of patient satisfaction. RESULTS: Facilitators were reported in the implementation domains ‘characteristics of the intervention’ and ‘characteristics of the individuals’. Barriers were in the implementation domains ‘inner setting’ and ‘implementation process’. Regarding patient satisfaction on nutrition counselling, 31% of the respondents wanted information prior to the counselling session, 22% received new information after consultation, 51% got motivated to change and 40% changed their nutritional behaviour. CONCLUSIONS: A considerable number of patients improved lifestyle after counselling, although, a relatively small number wanted lifestyle counselling prior to consultation. This study underlines the importance of implementation science and the information it provides for improving the implementation process

Provision of Palliative Care in Patients with COPD:A Survey Among Pulmonologists and General Practitioners

Contains fulltext : 232084.pdf (Publisher’s version ) (Open Access

A cluster randomized controlled trial on a multifaceted implementation strategy to promote integrated palliative care in COPD:study protocol of the COMPASSION study

Contains fulltext : 226222.pdf (publisher's version ) (Open Access

SERIES:eHealth in primary care. Part 4: Addressing the challenges of implementation

Background The implementation of eHealth applications in primary care remains challenging. Enhancing knowledge and awareness of implementation determinants is critical to build evidence-based implementation strategies and optimise uptake and sustainability. Objectives We consider how evidence-based implementation strategies can be built to support eHealth implementation. Discussion What implementation strategies to consider depends on (potential) barriers and facilitators to eHealth implementation in a given situation. Therefore, we first discuss key barriers and facilitators following the five domains of the Consolidated Framework for Implementation Research (CFIR). Cost is identified as a critical barrier to eHealth implementation. Privacy, security problems, and a lack of recognised standards for eHealth applications also hinder implementation. Engagement of key stakeholders in the implementation process, planning the implementation of the intervention, and the availability of training and support are important facilitators. To support care professionals and researchers, we provide a stepwise approach to develop and apply evidence-based implementation strategies for eHealth in primary care. It includes the following steps: (1) specify the eHealth application, (2) define problem, (3) specify desired implementation behaviour, and (4) choose and (5) evaluate the implementation strategy. To improve the fit of the implementation strategy with the setting, the stepwise approach considers the phase of the implementation process and the specific context. Conclusion Applying an approach, as provided here, may help to improve the implementation of eHealth applications in primary care.Prevention, Population and Disease management (PrePoD)Public Health and primary car

The FRESHAIR4Life study:Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations

In the FRESHAIR4Life study, we aim to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents’ exposure to tobacco use and air pollution (AP). This paper presents the methodology of FRESHAIR4Life and initial rapid review results. The rapid review showed variable NCD mortality rates related to tobacco use and AP exposure in the five participating countries. Tobacco is the predominant risk factor for NCD-related deaths in the Kyrgyz Republic, Greece, and Romania, whereas AP exposure causes most NCD-related deaths in Pakistan and Uganda. Adolescents’ risk factor exposure, sources of exposure, and trends also differ significantly. As the next step in FRESHAIR4Life, an in-depth situational analysis will inform the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. Subsequently, this package will be implemented, evaluated, and iteratively refined. Throughout the research process, a strong emphasis is on co-creation, capacity building, and comprehensive communication and dissemination

The FRESHAIR4Life study:Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations

In the FRESHAIR4Life study, we aim to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents’ exposure to tobacco use and air pollution (AP). This paper presents the methodology of FRESHAIR4Life and initial rapid review results. The rapid review showed variable NCD mortality rates related to tobacco use and AP exposure in the five participating countries. Tobacco is the predominant risk factor for NCD-related deaths in the Kyrgyz Republic, Greece, and Romania, whereas AP exposure causes most NCD-related deaths in Pakistan and Uganda. Adolescents’ risk factor exposure, sources of exposure, and trends also differ significantly. As the next step in FRESHAIR4Life, an in-depth situational analysis will inform the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. Subsequently, this package will be implemented, evaluated, and iteratively refined. Throughout the research process, a strong emphasis is on co-creation, capacity building, and comprehensive communication and dissemination

The FRESHAIR4Life study:Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations

In the FRESHAIR4Life study, we aim to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents’ exposure to tobacco use and air pollution (AP). This paper presents the methodology of FRESHAIR4Life and initial rapid review results. The rapid review showed variable NCD mortality rates related to tobacco use and AP exposure in the five participating countries. Tobacco is the predominant risk factor for NCD-related deaths in the Kyrgyz Republic, Greece, and Romania, whereas AP exposure causes most NCD-related deaths in Pakistan and Uganda. Adolescents’ risk factor exposure, sources of exposure, and trends also differ significantly. As the next step in FRESHAIR4Life, an in-depth situational analysis will inform the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. Subsequently, this package will be implemented, evaluated, and iteratively refined. Throughout the research process, a strong emphasis is on co-creation, capacity building, and comprehensive communication and dissemination

The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents’ exposure to tobacco and air pollution in disadvantaged populations

The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents’ exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.<br/