|
1
|
Kuiper D, Steverink N, Stewart RE, Reijneveld SA, Sanderman R, Goedendorp MM. Pace and determinants of implementation of the self-management of well-being group intervention: a multilevel observational study. BMC Health Serv Res 2019; 19:67. [PMID: 30683092 PMCID: PMC6346574 DOI: 10.1186/s12913-019-3891-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 01/09/2019] [Indexed: 02/02/2023] Open
Abstract
Background When implementing an empirically supported intervention (ESI) arrays of influencing factors operate on the professional and organizational level, but so far dependency between these levels has often been ignored. The aim of this study is to describe the pace and identify determinants of implementation of the Self-Management of Well-being (SMW) group intervention while taking the dependency between professionals and organizations into account. Methods Pace of implementation was measured as the time between training of professionals and first use of the SMW intervention in months. Determinants of first use were derived from the Fleuren framework and assessed using web-based questionnaires and telephone interviews. First, univariate analyses, Fisher’s exact tests and t-tests, were performed to identify determinants of first use of the SMW intervention on the individual professional and the organizational level independently. Second, multilevel analyses were performed to correct for the dependency between professionals and organizations. Simple multilevel logistic regression analyses were performed with determinants found significant in the univariate analyses as independent variables, first use as dependent variable, professionals entered in the first level, and organizations in the second level. Results Forty-eight professionals from 18 organizations were trained to execute the SMW intervention. Thirty-two professionals achieved first use, at a mean pace of 7.5 months ± 4.2. Determinants on the professional level were ‘ownership’, ‘relative advantage’, ‘support from colleagues’ and ‘compatibility’. Determinants on the organizational level were ‘organizational size’ and ‘innovation-task orientation fit’. Multilevel analysis showed that ‘compatibility’, a factor on the professional level, was the only significant determinant contributing to first use in the multilevel model. Conclusions This implementation study revealed a strong dependency between professionals and organizations. Results showed that a majority of professionals used the SMW intervention in about 8 months. When the dependency between professionals and organization was taken into account, the professionals’ perception of compatibility was the only remaining determinant of implementation on the professional level. Organizational size and managers’ perception of ‘innovation-task orientation fit’ were determinants of implementation on the organizational level. It is advisable to discuss the compatibility between new and current tasks among managers and professionals before adopting a new intervention. Electronic supplementary material The online version of this article (10.1186/s12913-019-3891-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Daphne Kuiper
- Service Desk Clinical Research Office, UMC staff, University Medical Center Groningen, P.O. Box 30.001, AB41, 9700 RB, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, FA12, 9700 AD, Groningen, The Netherlands
| | - Nardi Steverink
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, FA12, 9700 AD, Groningen, The Netherlands.,Department of Sociology, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - Roy E Stewart
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 196, FA10, 9700 AD, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, (Community & Occupational Medicine) University Medical Center Groningen, University of Groningen, P.O. Box 196, FA10, 9700 AD, Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, FA12, 9700 AD, Groningen, The Netherlands.,Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, FA12, 9700 AD, Groningen, The Netherlands. .,Department of Health Science, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands.
| |
Collapse
|
|
2
|
Goedendorp MM, Kuiper D, Reijneveld SA, Sanderman R, Steverink N. Sustaining program effectiveness after implementation: The case of the self-management of well-being group intervention for older adults. PATIENT EDUCATION AND COUNSELING 2017; 100:1177-1184. [PMID: 28089311 DOI: 10.1016/j.pec.2017.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 01/05/2017] [Accepted: 01/09/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity. METHODS In the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants' baseline characteristics. Professionals completed questions regarding program fidelity. RESULTS No significant differences were found on effect outcomes and adherence between IMP and RCT (all p≥0.135). Intervention effect sizes were equal (0.47-0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations. CONCLUSION The effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity. PRACTICE IMPLICATIONS The SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.
Collapse
Affiliation(s)
- Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Daphne Kuiper
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Clinical Research Office, UMC staff, University Medical Center Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, (Community & Occupational Medicine,) University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
| | - Nardi Steverink
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Sociology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|