Implementation of web-based interventions by Dutch occupational health centers

The aim of this qualitative study was to identify barriers and facilitators to the adoption and particularly the implementation of a web-based computer-tailored obesity prevention intervention by occupational health centers. Participants were directors of Dutch occupational health centers who had adopted and implemented the intervention for the corresponding efficacy study (n = 8) as well as non-adopters (n = 12). Individual semi-structured interviews were carried out to study barriers and facilitators related to the intervention, the user, the organization, and the socio-political environment. All interviews were carried out by telephone, audio-recorded and transcribed verbatim. The transcripts were analyzed using a directed-content approach and coded by two persons. There were important differences in perceptions between adopters and non-adopters, particularly on barriers and facilitators related to the intervention and the personal beliefs of the implementer. The relative advantages of the intervention were considered to be most important. Participants also indicated that their personal attitudinal and self-efficacy beliefs influenced their implementation efforts. Regarding the organization, the possibilities to increase profits and integrate the intervention within the organization were considered to be important facilitators for the implementation. Participants mentioned few implementation barriers and facilitators related to the socio-political environment. Strategies to improve the implementation of web-based computer-tailored interventions by occupational health centers should be tailored to implementers' unique perceptions and particularly address the perceived advantages and disadvantages of the intervention, attitudinal and self-efficacy beliefs, and the potential to increase organizations' profits and competitiveness.

[1]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[2]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[3]  W. van Mechelen,et al.  Barriers and Facilitators to Implementation of an Occupational Health Guideline Aimed at Preventing Weight Gain Among Employees in the Netherlands , 2012, Journal of occupational and environmental medicine.

[4]  I. Ajzen.  The theory of planned behavior , 1991 .

[5]  F. Mair,et al.  Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review. , 2012, Bulletin of the World Health Organization.

[6]  J. Grimshaw,et al.  From best evidence to best practice: effective implementation of change in patients' care , 2003, The Lancet.

[7]  S. Kremers,et al.  Factors determining the motivation of primary health care professionals to implement and continue the 'Beweegkuur' lifestyle intervention programme. , 2012, Journal of evaluation in clinical practice.

[8]  Elizabeth A. Matos.  From best evidence to best practice , 2017 .

[9]  Willem Van Mechelen,et al.  What is actually measured in process evaluations for worksite health promotion programs: a systematic review , 2013, BMC Public Health.

[10]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[11]  P. Sainsbury,et al.  Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. , 2007, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[12]  Martin Eccles,et al.  Implementing clinical guidelines: current evidence and future implications. , 2004, The Journal of continuing education in the health professions.

[13]  F. Mair,et al.  Why is it difficult to implement e-health initiatives? A qualitative study , 2011, Implementation science : IS.

[14]  Michel Wensing,et al.  What drives change? Barriers to and incentives for achieving evidence‐based practice , 2004, The Medical journal of Australia.

[15]  Stephenie R. Chaudoir,et al.  Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures , 2013, Implementation Science.

[16]  Alireza Ahmadvand.  CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions , 2011 .

[17]  Lars Wallin,et al.  Individual determinants of research utilization by nurses: a systematic review update , 2011, Implementation science : IS.

[18]  Jennifer L. Pomeranz,et al.  The Delivery of Public Health Interventions via the Internet: Actualizing Their Potential , 2011 .

[19]  J. Brug,et al.  Web-based tailored nutrition education: results of a randomized controlled trial. , 2001, Health education research.

[20]  Anke J. E. de Veer,et al.  Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users , 2011, BMC Medical Informatics Decis. Mak..

[21]  H. Hearnshaw,et al.  Randomised controlled trial of tailored strategies to implement guidelines for the management of patients with depression in general practice. , 2001, The British journal of general practice : the journal of the Royal College of General Practitioners.

[22]  Anke Oenema,et al.  Systematic development of a text-driven and a video-driven web-based computer-tailored obesity prevention intervention , 2013, BMC Public Health.

[23]  T. Vos,et al.  Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study , 2009, PLoS medicine.

[24]  H. de Vries,et al.  Correlates of the Intention to Implement a Tailored Physical Activity Intervention: Perceptions of Intermediaries , 2014, International journal of environmental research and public health.

[25]  J. Lowery,et al.  Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science , 2009, Implementation science : IS.

[26]  W. E. van der Weide,et al.  Evaluation research in occupational health services: general principles and a systematic review of empirical studies. , 1999, Occupational and environmental medicine.

[27]  P. Ray,et al.  Health Care Provider Adoption of eHealth: Systematic Literature Review , 2013, Interactive journal of medical research.

[28]  C. Haslam,et al.  Implementing Health and Safety Interventions in the Workplace: An Exploratory Study , 2006 .

[29]  J. Durlak,et al.  Implementation Matters: A Review of Research on the Influence of Implementation on Program Outcomes and the Factors Affecting Implementation , 2008, American journal of community psychology.

[30]  Anke J. E. de Veer,et al.  Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review , 2008, BMC Medical Informatics Decis. Mak..

[31]  K. Klein,et al.  The Challenge of Innovation Implementation , 1996 .

[32]  G. Robert,et al.  Diffusion of innovations in service organizations: systematic review and recommendations. , 2004, The Milbank quarterly.

[33]  A Burdorf,et al.  Determinants of implementation of primary preventive interventions on patient handling in healthcare: a systematic review , 2009, Occupational and Environmental Medicine.

[34]  Christian D Helfrich,et al.  Determinants of Implementation Effectiveness , 2007, Medical care research and review : MCRR.

[35]  Maria E. Fernandez,et al.  Planning Health Promotion Programs: An Intervention Mapping Approach , 2006 .

[36]  S. Shortell,et al.  Assessing the impact of continuous quality improvement on clinical practice: what it will take to accelerate progress. , 1998, The Milbank quarterly.

[37]  H. de Vries,et al.  Determinants of practice nurses' intention to implement a new smoking cessation intervention: the importance of attitude and innovation characteristics. , 2013, Journal of advanced nursing.

[38]  Jeffrey R. Harris,et al.  Understanding the Decision-Making Process for Health Promotion Programming at Small to Midsized Businesses , 2011, Health promotion practice.

[39]  Tara M Cousineau,et al.  A pilot study of an online workplace nutrition program: the value of participant input in program development. , 2008, Journal of nutrition education and behavior.

[40]  R. Grol,et al.  Implementation Barriers for General Practice Guidelines on Low Back Pain: A Qualitative Study , 2001, Spine.

[41]  T. Paulussen,et al.  Determinants of innovation within health care organizations: literature review and Delphi study. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[42]  Bryan J Weiner,et al.  Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. , 2008, Health education research.

[43]  D. Mahoney,et al.  Real world implementation lessons and outcomes from the Worker Interactive Networking (WIN) project: workplace-based online caregiver support and remote monitoring of elders at home. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[44]  M. Eccles,et al.  Falling on stony ground? A qualitative study of implementation of clinical guidelines' prescribing recommendations in primary care. , 2008, Health policy.

[45]  Graham Pervan,et al.  ICT and OTs: A model of information and communication technology acceptance and utilisation by occupational therapists , 2007, Int. J. Medical Informatics.