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An iterative approach to developing a multifaceted implementation strategy for a complex eHealth intervention within clinical practice.
IJzerman, Renée V H; van der Vaart, Rosalie; Breeman, Linda D; Arkenbout, Karin; Keesman, Mike; Kraaijenhagen, Roderik A; Evers, Andrea W M; Scholte Op Reimer, Wilma J M; Janssen, Veronica R.
Afiliación
  • IJzerman RVH; Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333, the Netherlands. r.v.h.ijzerman@fsw.leidenuniv.nl.
  • van der Vaart R; Centre of expertise Health Innovation, The Hague University of Applied Sciences, Den Haag, the Netherlands.
  • Breeman LD; Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333, the Netherlands.
  • Arkenbout K; Department of Cardiology, Tergooi MC, Blaricum and Hilversum, the Netherlands.
  • Keesman M; Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333, the Netherlands.
  • Kraaijenhagen RA; Vital10, Amsterdam, the Netherlands.
  • Evers AWM; Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333, the Netherlands.
  • Scholte Op Reimer WJM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Janssen VR; Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands.
BMC Health Serv Res ; 23(1): 1455, 2023 Dec 21.
Article en En | MEDLINE | ID: mdl-38129824
ABSTRACT

BACKGROUND:

The number of complex eHealth interventions has increased considerably. Despite available implementation theory outlining well-designed strategies, implementing complex interventions within practice proves challenging and often does not lead to sustainable use. To improve sustainability, theory and practice should be addressed during the development of an implementation strategy. By subsequently transparently reporting the executed theory-based steps and their corresponding practice findings, others can learn from these valuable lessons learned. This study outlines the iterative approach by which a multifaceted implementation strategy for a complex eHealth intervention in clinical practice was developed, tested and refined.

METHODS:

We implemented the BENEFIT program, an advanced eHealth platform with Personal Health Portal facilitating healthy living in cardiac patients. In six iterative phases alternating between theory and practice, the implementation strategy was developed, tested and refined. The initial implementation strategy (phase 1) was drawn up using the Implementation model and RE-AIM. Subsequently, this strategy was further updated in brainstorming sessions and group discussions with twenty key stakeholders from three cardiac care centres and then evaluated in a pilot (phases 2 and 3).

RESULTS:

The pilot of the program led to the identification of (context-specific) key challenges in practice (phase 4), which were subsequently connected back to broader theory (phase 5) using the Consolidated Framework of Implementation Research (CFIR). In the final phase, practice recommendations tackling the key challenges were formulated (phase 6) based on CFIR theory, the CFIR-ERIC Matching Tool, and stakeholders' input and feedback. These recommendations were then added to the refined strategy. Thus, executing this approach led to the realisation and use of a multifaceted theory-informed practice-based implementation strategy.

CONCLUSION:

This case study gives an in-depth description of an iterative approach to developing an evidence-based, practice-tailored strategy for implementing a complex eHealth intervention in cardiac care. As such, this study may serve as a blueprint for other researchers aspiring to implement complex eHealth interventions within clinical practice sustainably.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina Límite: Humans Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina Límite: Humans Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido