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Nilsagård, Y., Smith, D. R., Söderqvist, F., Nilsing Strid, E. & Wallin, L. (2025). Achieving health-promotion practice in primary care using a multifaceted implementation strategy: a non-randomized parallel group study. Implementation Science Communications, 6(1), Article ID 36.
Open this publication in new window or tab >>Achieving health-promotion practice in primary care using a multifaceted implementation strategy: a non-randomized parallel group study
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2025 (English)In: Implementation Science Communications, E-ISSN 2662-2211, Vol. 6, no 1, article id 36Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Evidence-based healthcare recommendations exist for tobacco use, harmful alcohol consumption, low physical activity, and poor diet. However, the uptake of these recommendations in Swedish primary healthcare is poor, and the potential benefits for patients are not fully realized. Our aim was to evaluate the effect (i.e. the uptake) of a 12-month multifaceted implementation strategy to achieve a more health-promoting practice. We hypothesized that primary healthcare centers receiving this strategy would increase and sustain their health-promotion practices to a significantly greater extent than control centers, from baseline to the 6-month follow-up.

METHODS: In a non-randomized parallel group study, 5 intervention centers and 5 matched control centers were compared regarding health-promotion activities delivered in relation to visits to each center. The intervention centers received a multifaceted implementation strategy over at least 12 months based on established strategies, the Astrakan model of leading change, and findings from pre-implementation studies. The main strategies were: using external and internal facilitators to combine bottom-up and top-down perspectives, and emphasizing leadership responsibility for change. Medical record data on health-promotion activities, including prescribed physical activity and use of lifestyle screening forms, were collected monthly for 2 years: 6 months before and after implementation, and during the implementation phase. The implementation strategy effect was estimated using generalized linear mixed models.

RESULTS: During the 12-month implementation phase, the intervention and control sites had 135 002 and 160 987 healthcare visits, respectively; conducted 8839 and 6171 health-promotion activities, respectively; and administered 2423 and 282 lifestyle screening forms, respectively. A statistically significant higher relative uptake rate of health-promotion activities was found in intervention sites compared to control sites after the implementation period compared to before. The effect increased during the active phase, with the intervention sites having on average 1.07 and 2.0 times the uptake rate of the control sites at 1 and 12 months, respectively; this effect was largely maintained during the 6-month post-intervention phase. A significant absolute effect, in terms of difference in predicted uptake per 1000 visits, was evident 7 months into the implementation phase.

CONCLUSION: This multi-faceted implementation strategy was successful in achieving a more health-promoting practice.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Change Management, Clinical Practice Guidelines, Health Promotion, Healthy Lifestyle, Implementation Science, Primary Health Care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-120446 (URN)10.1186/s43058-025-00723-y (DOI)001463755400001 ()40197376 (PubMedID)2-s2.0-105002896929 (Scopus ID)
Funder
Örebro UniversityRegion Örebro County, OLL-96956
Available from: 2025-04-09 Created: 2025-04-09 Last updated: 2025-04-28Bibliographically approved
Hälleberg Nyman, M., Nilsagård, Y., Nilsing Strid, E. & Fjordkvist, E. (2025). One fracture is enough!: Support for implementation of a new care process. In: : . Paper presented at European Implementation Event 2025 (EIE 2025), Newcastle upon Tyne, June 4-6, 2025.
Open this publication in new window or tab >>One fracture is enough!: Support for implementation of a new care process
2025 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-120414 (URN)
Conference
European Implementation Event 2025 (EIE 2025), Newcastle upon Tyne, June 4-6, 2025
Funder
Nyckelfonden, 999960
Available from: 2025-04-04 Created: 2025-04-04 Last updated: 2025-04-23Bibliographically approved
Peterson, G., Nilsing Strid, E., Jönsson, M., Hävermark, J. & Peolsson, A. (2024). Effect of neck-specific exercises with and without internet support on cervical range of motion and neck muscle endurance in chronic whiplash-associated disorders: analysis of functional outcomes of a randomized controlled trial. Journal of Rehabilitation Medicine, 56, Article ID 34785.
Open this publication in new window or tab >>Effect of neck-specific exercises with and without internet support on cervical range of motion and neck muscle endurance in chronic whiplash-associated disorders: analysis of functional outcomes of a randomized controlled trial
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2024 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 56, article id 34785Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To compare the effects of a neck-specific exercise programme with internet support and 4 physiotherapist sessions (NSEIT) and the same neck-specific exercises supervised by a physiotherapist (NSE) on neck muscle endurance and cervical range of motion. DESIGN: Randomized controlled trial. PATIENTS: A total of 140 participants with chronic whiplash-associated disorders grade II or grade III were randomly assigned to the NSEIT or NSE groups.

METHODS: Outcomes were changes in active cervical range of motion, cranio-cervical flexion test, neck muscle endurance, and neck pain, at 3- and 15-month follow-ups.

RESULTS: There were no significant differences between the NSEIT and NSE groups. There was a significant group-by-time inter-action effect in active cervical range of motion flexion/extension where the NSEIT group improved to 3-month follow-up, but the NSE group did not. Both groups were significantly improved over time in all other outcomes (p < 0.001) at 3- and 15-month follow-ups, with effect size between 0.64 and 1.35 in active cervical range of motion, cranio-cervical flexion test, dorsal neck muscle endurance, and neck pain, and effect size between 0.22 and 0.42 in ventral neck muscle endurance.

CONCLUSION: Both NSE and NSEIT led to improved neck function. Depending on the patients' needs, either NSE or NSEIT could be used as treatment for patients with chronic whiplash-associated disorders.

Place, publisher, year, edition, pages
Foundation for Rehabilitation Information, 2024
National Category
Physiotherapy
Identifiers
urn:nbn:se:oru:diva-115426 (URN)10.2340/jrm.v56.34785 (DOI)001280772600001 ()39072427 (PubMedID)2-s2.0-85201597084 (Scopus ID)
Funder
Vinnova, 2018-02244Swedish Research Council, 2018-02476Uppsala University, 736751; 854531; 930399Södra sjukvårdsregionen, 844451; 939838Region Östergötland, 676261; 847691
Note

The study was funded by: Vinnova (grant number 2018-02244), the Swedish Research Council (grant number 2018-02476), the Centre for Clinical Research Sörmland at Uppsala University Sweden (grant numbers 736751, 854531, 930399), the Regional Research Council Mid Sweden (grant number 641551, 838701, 939243), the Medical Research Council of Southeast Sweden (grant numbers 844451, 939838), and Östergötland County Council (grant numbers 676261, 847691).

Available from: 2024-08-16 Created: 2024-08-16 Last updated: 2025-02-11Bibliographically approved
Nilsing Strid, E., Wallin, L. & Nilsagård, Y. (2024). Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals. Scandinavian Journal of Primary Health Care, 42(1), 201-213
Open this publication in new window or tab >>Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals
2024 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 42, no 1, p. 201-213Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professionals on supporting change was explored.

DESIGN: This study had an explorative qualitative design using data gathered from individual interviews and focus groups. Qualitative content analysis with a deductive category development was applied using the Consolidated Framework for Implementation Research.

SETTING AND PARTICIPANTS: The study was conducted in a primary care setting in central Sweden as a part of the Act in Time research project. Prior to a multifaceted implementation strategy, we held 16 individual interviews with managers and appointed facilitators and five focus groups with 26 health care professionals.

RESULTS: Managers, facilitators, and professionals held similar expectations, where their expressed need for support corresponded to three constructs: Readiness for implementation, Implementation climate, and Engaging. Our findings indicate the need for strong leadership engagement to focus on how the healthy lifestyle-promoting practice can be anchored among the professionals. Managers at all levels should communicate the vision and goals, enable facilitators and professionals to improve their competencies, build inter-professional teams, and jointly plan the new practice.

CONCLUSION: To change to a healthy lifestyle promoting practice professionals request support from their managers, who in turn need support from the middle and top managers. The requested support includes helping to prioritise health promotion and enabling the primary care centres to build competence and take ownership of the implementation.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04799860.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Qualitative research, health personnel, healthy lifestyle, implementation science, leadership, practice guidelines, primary health care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-111025 (URN)10.1080/02813432.2023.2301556 (DOI)001145189500001 ()38241166 (PubMedID)2-s2.0-85182677608 (Scopus ID)
Funder
Region Örebro County, OLL-969561
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-03-22Bibliographically approved
Westerling, U., Hellgren, M., Hermansson, L. & Nilsing Strid, E. (2024). Informal caregivers' experiences of support from a tailored primary healthcare unit for older adults: A focus group study. Scandinavian Journal of Caring Sciences, 38(3), 730-744
Open this publication in new window or tab >>Informal caregivers' experiences of support from a tailored primary healthcare unit for older adults: A focus group study
2024 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, no 3, p. 730-744Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Informal caregivers are an essential part of health and social care systems worldwide. As such, they may need professional support. AIM: The aim of this study was to describe informal caregivers' experiences and need for support from a tailored primary health care (PHC) unit.

METHODS: This is a qualitative descriptive study using data collected from five semi-structured focus group discussions with a purposeful sample of 16 informal caregivers of older relatives. Respondents were recruited from a tailored PHC unit for people aged 75 years or older in a region in central Sweden. The data were analysed by qualitative content analysis with an abductive approach, based on the principles of the patient- and family-centred care framework.

RESULTS: The overarching theme was 'Striving for partnership'. The findings indicate that informal caregivers to some extent felt supported by the healthcare professionals. However, the caregivers expressed a need to be further acknowledged by the professionals in order to participate in the care of their older relatives in the way they wanted. Moreover, insufficient information regarding the older adult's health condition and care provided by the professionals had a negative impact on the caregiver's participation in care.

CONCLUSIONS: Informal caregivers have unmet needs for support and strive for a partnership with the PHC professionals. PHC professionals should be more attentive and invite informal caregivers to participate in the care of the older adult in order to meet their support needs and build an equal partnership. The patient- and family-centred care framework may be of guidance when providing care for older adults in a PHC context.

Place, publisher, year, edition, pages
Blackwell Publishing, 2024
Keywords
Aged, caregivers, focus groups, patient‐centred care, primary health care, professional–family relations, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-113056 (URN)10.1111/scs.13260 (DOI)001198603500001 ()38591362 (PubMedID)2-s2.0-85190439314 (Scopus ID)
Funder
Region Örebro County
Available from: 2024-04-10 Created: 2024-04-10 Last updated: 2024-09-02Bibliographically approved
Peolsson, A., Nilsing Strid, E. & Peterson, G. (2024). Novel Internet Support for Neck-Specific Rehabilitation Improves Work-Related Outcomes to the Same Extent as Extensive Visits to a Physiotherapy Clinic in Individuals with Chronic Whiplash-Associated Disorders: A Prospective Randomised Study. Journal of occupational rehabilitation, 34(4), 873-883
Open this publication in new window or tab >>Novel Internet Support for Neck-Specific Rehabilitation Improves Work-Related Outcomes to the Same Extent as Extensive Visits to a Physiotherapy Clinic in Individuals with Chronic Whiplash-Associated Disorders: A Prospective Randomised Study
2024 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 34, no 4, p. 873-883Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To address the current lack of information about work-related factors for individuals with whiplash-associated disorders (WAD) we investigated the effectiveness of 3 months of neck-specific rehabilitation with internet support in combination with four physiotherapy visits (NSEIT) compared to the same exercises performed twice a week (24 times) at a physiotherapy clinic (NSE).

METHODS: This is a prospective, multicentre, randomised controlled trial regarding secondary outcomes of work-related factors in 140 individuals with chronic moderate/severe WAD with 3- and 15-month follow-up.

RESULTS: There were no group differences between NSE and NSEIT in the Work Ability Scale or work subscales of the Neck Disability Index, Whiplash Disability Questionnaire or Fear Avoidance Beliefs Questionnaire (FABQ-work). Both groups improved in all work-related outcome measures, except for FABQ-work after the 3-month intervention and results were maintained at the 15-month follow-up.

CONCLUSIONS: Despite fewer physiotherapy visits for the NSEIT group, there were no group differences between NSEIT and NSE, with improvements in most work-related measures maintained at the 15-month follow-up. The results of the present study are promising for those with remaining work ability problems after a whiplash injury. Protocol registered before data collection started: clinicaltrials.gov NCT03022812.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Exercise Therapy, Internet-Based Intervention, Spine, Whiplash Injuries, Work
National Category
Physiotherapy
Identifiers
urn:nbn:se:oru:diva-112621 (URN)10.1007/s10926-024-10176-0 (DOI)001190397800001 ()38526764 (PubMedID)2-s2.0-85188546765 (Scopus ID)
Funder
Linköpings universitetSwedish Research CouncilVinnovaRegion ÖstergötlandRegion Sörmland
Note

Open access funding provided by Linköping University. Funding was received in competition and paid to the Department of Health, Medicine and Caring Sciences, Linköping University or to the Centre for Clinical Research Sörmland, Uppsala University. The authors acknowledge financial support from the Swedish Research Council, the Swedish Innovation Agency, the Medical Research Council of Southeast Sweden, and the county councils of Östergötland and Sörmland.

Available from: 2024-03-26 Created: 2024-03-26 Last updated: 2025-02-11Bibliographically approved
Tofiq, a., Eriksson Crommert, M., Zakrisson, A.-B., von Euler, M. & Nilsing Strid, E. (2024). Physical functioning post-COVID-19 and the recovery process: a mixed methods study. Disability and Rehabilitation, 46(8), 1570-1579
Open this publication in new window or tab >>Physical functioning post-COVID-19 and the recovery process: a mixed methods study
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2024 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 46, no 8, p. 1570-1579Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To describe physical functioning after severe COVID-19-infection.

MATERIALS AND METHOD: An explanatory sequential mixed method design was used. Thirty-nine participants performed tests and answered questionnaires measuring physical functioning six months after hospitalisation due to COVID-19. Thirty of these participants participated in semi-structured interviews with questions regarding how they perceived their physical functioning and recovery from COVID-19 at 12 months post-hospitalisation.

RESULTS: At six months, physical functioning measured via chair stand test and hip-worn accelerometers was lower than normal reference values. There was a reduction in breathing muscle strength. Participants estimated their functional status during different activities as lower compared to those before COVID-19-infection, measured with a patient-specific functional scale. At one year after infection, there were descriptions of a rough recovery process and remaining symptoms.

CONCLUSION: Patients recovering from severe COVID-19 seem to have reduced physical functioning and activity levels, and they perceive their recovery to be slow and difficult. They experienced a lack of clinical support and contradictory advice regarding rehabilitation. Coaching in returning to physical functioning after the infection needs to be better co-ordinated and there is a need for guidelines for health professionals to avoid patients receiving contradictory advice.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
COVID-19, SARS-CoV-2, exercise, physical activity, qualitative research, recovery of function, rehabilitation, severe acute respiratory syndrome
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:oru:diva-105614 (URN)10.1080/09638288.2023.2201512 (DOI)000971399700001 ()37078388 (PubMedID)2-s2.0-85153473582 (Scopus ID)
Available from: 2023-04-21 Created: 2023-04-21 Last updated: 2025-02-11Bibliographically approved
Wåhlin, C., Buck, S., Enthoven, P., Andreassen, M., Sandqvist, J., Haraldsson, P., . . . Nilsing Strid, E. (2024). Risk assessment of healthcare workers' exposure to physical load in relation to patient handling and movement: a feasibility study of the instrument TilThermometer. BMC Musculoskeletal Disorders, 25(1), Article ID 399.
Open this publication in new window or tab >>Risk assessment of healthcare workers' exposure to physical load in relation to patient handling and movement: a feasibility study of the instrument TilThermometer
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2024 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 25, no 1, article id 399Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Work-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health. The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs' perceptions and experiences of using the TilThermometer.

METHODS: This feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs' experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness.

RESULTS: The TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units' recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with questions evaluating usefulness.

CONCLUSION: The risk assessment provided risk profiles with potential to contribute to care units' development of a safe patient handling and movement practice. The findings suggest that the TilThermometer can be used to assess risks for physical exposure in relation to patient handling and movement in care units at hospital and nursing homes.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Ergonomics, Health personnel workers, Nursing, Occupational health, Risk assessment, Safety management, Working conditions environment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:oru:diva-113756 (URN)10.1186/s12891-024-07508-9 (DOI)001228658400005 ()38773516 (PubMedID)2-s2.0-85193934418 (Scopus ID)
Funder
Linköpings universitetAFA Insurance, 190144Region Östergötland
Available from: 2024-05-22 Created: 2024-05-22 Last updated: 2025-01-20Bibliographically approved
Wåhlin, C., Buck, S., Sandqvist, J., Enthoven, P., Fock, J., Andreassen, M. & Nilsing Strid, E. (2023). Evaluation of the implementation and effectiveness of a multifactorial intervention strategy for safe patient handling and movement in the healthcare sector: a study protocol of a cluster randomised controlled trial. BMJ Open, 13(2), Article ID e067693.
Open this publication in new window or tab >>Evaluation of the implementation and effectiveness of a multifactorial intervention strategy for safe patient handling and movement in the healthcare sector: a study protocol of a cluster randomised controlled trial
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 2, article id e067693Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Healthcare workers with physically demanding work tasks, such as patient handling and movement (PHM), are at high risk of musculoskeletal disorders. To facilitate safe PHM and prevent musculoskeletal disorders, a combination of workplace interventions, including risk assessments, is needed. The aim of this study is to implement and evaluate a multifactorial intervention strategy for safe PHM and compare it with a single intervention strategy.

METHODS AND ANALYSIS: This cluster randomised controlled trial will compare a multifactorial intervention strategy with a single intervention strategy for safe PHM in workplaces in the Swedish regional and municipal healthcare systems. At least twelve healthcare units will be recruited. Care units belonging to arm A will receive: (1) guidelines for PHM, (2) training modules, (3) risk assessment with TilThermometer, (4) risk assessment with Downtown Fall Risk Index and (5) work environment mapping. Care units belonging to Arm B will receive interventions (1) and (5). The two strategies will be evaluated with regards to (1) the primary outcome of the applied strategies' intervention effectiveness (safety climate in relation to aspects of PHM) and (2) the primary implementation outcome (acceptability, appropriateness and feasibility). This study will also explore the implementation process and intervention fidelity, examine the influence of contextual factors and investigate participants' experiences of working with strategies for safe PHM. A mix of quantitative and qualitative methods will be used. The data collection is based on questionnaires, interviews and field notes of contextual factors.

ETHICS AND DISSEMINATION: The study is approved by the Swedish national ethical board (Dnr 2021-00578). Study results will be published in peer-reviewed journals, presented at conferences and distributed on social media. A lay summary and dissemination strategy will be codesigned with a reference group and participating healthcare units.

TRIAL REGISTRATION NUMBER: NCT05276180.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
Health & safety, Musculoskeletal disorders, PUBLIC HEALTH
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:oru:diva-104033 (URN)10.1136/bmjopen-2022-067693 (DOI)001000964400010 ()36737081 (PubMedID)2-s2.0-85147458370 (Scopus ID)
Funder
Afa Sjukförsäkringsaktiebolag, 190144
Note

Study protocol

Available from: 2023-02-06 Created: 2023-02-06 Last updated: 2025-02-20Bibliographically approved
Nilsing Strid, E., Wallin, L. & Nilsagård, Y. (2023). Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study. BMC Primary Care, 24(1), Article ID 122.
Open this publication in new window or tab >>Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study
2023 (English)In: BMC Primary Care, E-ISSN 2731-4553, Vol. 24, no 1, article id 122Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals' (HCPs') perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC.

METHODS: In this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis.

RESULTS: Twelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation.

CONCLUSIONS: The HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs.

TRIAL REGISTRATION: This study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860. Registered 03 March 2021.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Change Management, Clinical Practice Guidelines, Health Personnel, Healthy Lifestyle, Implementation Science, Primary Health Care, Qualitative Research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-106397 (URN)10.1186/s12875-023-02079-5 (DOI)001012438000003 ()37328813 (PubMedID)2-s2.0-85162070185 (Scopus ID)
Funder
Örebro UniversityRegion Örebro County, OLL-969561
Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2024-04-05Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0483-8981

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