Experiences with tailoring of primary diabetes care in well-organised general practices: a mixed-methods study

Bruggen, Sytske van; Kasteleyn, Marise J.; Rauh, Simone P.; Meijer, Julia; Busch, Karin; Numans, Mattijs E.; Chavannes, Niels H.

doi:10.1186/s12913-021-07198-2

Cited by 3 publications

(2 citation statements)

References 46 publications

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“…The reported decline in delivery of diabetes care is in line with general observations concerning covid-related decreases in care volumes [35] as well as the negative impact of consultation reductions on people with diabetes [36] , [37] , [38] . Considering the frequently reported exhaustion and burnout of healthcare providers during the covid pandemic [39] , [40] , the absence of health and wellbeing-related problems is surprising.…”

Section: Discussionsupporting

confidence: 83%

The impact of the covid-19 pandemic on diabetes care: the perspective of healthcare providers across Europe

Grondelle¹,

Bruggen²,

Rauh³

et al. 2023

Primary Care Diabetes

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Section: Discussionsupporting

confidence: 83%

The impact of the covid-19 pandemic on diabetes care: the perspective of healthcare providers across Europe

Grondelle¹,

Bruggen²,

Rauh³

et al. 2023

Primary Care Diabetes

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“… Low quality/low relevance studies not included in synthesis: [ 43 , 46 , 51 , 52 , 60 , 63 , 64 , 66 , 69 , 71 , 73 , 76 , 79 , 82 , 87 , 90 , 93 , 96 ] …”

Section: Resultsmentioning

confidence: 99%

Teamwork and implementation of innovations in healthcare and human service settings: a systematic review

McGuier,

Kolko,

Aarons

et al. 2024

Implementation Sci

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Background Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations. However, team constructs and team-based implementation approaches have received little attention in the implementation science literature. This systematic review summarizes empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings. Methods We searched MEDLINE, CINAHL, APA PsycINFO and ERIC for peer-reviewed empirical articles published from January 2000 to March 2022. Additional articles were identified by searches of reference lists and a cited reference search for included articles (completed in February 2023). We selected studies using quantitative, qualitative, or mixed methods to examine associations between team constructs and implementation outcomes in healthcare and human service settings. We used the Mixed Methods Appraisal Tool to assess methodological quality/risk of bias and conducted a narrative synthesis of included studies. GRADE and GRADE-CERQual were used to assess the strength of the body of evidence. Results Searches identified 10,489 results. After review, 58 articles representing 55 studies were included. Relevant studies increased over time; 71% of articles were published after 2016. We were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. Qualitative findings with high confidence were: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier. Conclusions Teamwork matters for implementation. However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies. Greater specificity and rigor are needed to understand how teamwork influences implementation processes and outcomes. We provide recommendations for improving the conceptualization, description, assessment, analysis, and interpretation of research on teams implementing innovations. Trial registration This systematic review was registered in PROSPERO, the international prospective register of systematic reviews. Registration number: CRD42020220168.

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Evaluation of the Implementation of a Mobile Health Application to Support Dutch Primary Care for Diabetes: A Qualitative Study (Preprint)

van den Berg,

te Lindert,

Aardoom

et al. 2023

Preprint

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BACKGROUND Over 1 million Dutch people have diabetes, 90% of whom have type 2 diabetes. Studies show that lifestyle plays an important role in the course of type 2 diabetes. MiGuide is an online platform that helps people adopt and maintain lifestyle changes in their daily lives. The platform is integrated into existing diabetes care within primary care. Previous research has shown that the implementation of new (eHealth) interventions is challenging, which is at the expense of effectiveness. Mapping out the barriers and success factors of the implementation process is essential, so that eHealth interventions such as MiGuide can be used effectively in regular healthcare. OBJECTIVE This study aimed to evaluate the implementation of MiGuide within Dutch primary care. METHODS A qualitative study design was used, supplemented by quantitative data from patients. Five general practices participated. Three focus groups (at baseline, after six months and after 12 months) were conducted with three general practitioners, three focus groups with eight specialized practice nurses (divided into two separate groups with four participants per group), two focus groups (at six months and after 12 months) with five patients and two focus groups (at baseline and after 12 months) with four stakeholders from the management of the care group. The implementation process was discussed with HCPs and management, and usage and user-friendliness were discussed with patients. The Framework method was used to analyse the data. The following quantitative data were collected: patient characteristics, user data and questionnaires at baseline and six months assessing quality of life, usability and diabetes self-care. The quantitative data were examined with exploratory analyses. RESULTS Four themes were found in the qualitative data: “innovation”, “capability, motivation and opportunity”, “processes”, and “setting”. Different factors within these themes played an essential role throughout the implementation process, such as facilities, technical difficulties, motivation, COVID-19 and current work processes. Areas of improvement were also identified. The supplemented quantitative data showed that usability scored below average at six months (M=53.8, n=8). Participants had a mean score of 0.84 on the EQ-5D and 81.9 on the EQ-VAS at baseline. Moreover, the average amount of days someone exercised was 4.2 and that someone ate a generally healthy diet was 5.1. Insufficient data about the quality of life and diabetes self-care was collected at six months and therefore not presented in this study. CONCLUSIONS Implementation is a complex process with multiple barriers and facilitators. It is essential to explore the use of context-specific strategies that are aligned with the implementation process phase. Further research is needed to evaluate the next version of the MiGuide platform, which is implemented in another setting with lifestyle coaches.

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Experiences with tailoring of primary diabetes care in well-organised general practices: a mixed-methods study

Cited by 3 publications

References 46 publications

The impact of the covid-19 pandemic on diabetes care: the perspective of healthcare providers across Europe

The impact of the covid-19 pandemic on diabetes care: the perspective of healthcare providers across Europe

Teamwork and implementation of innovations in healthcare and human service settings: a systematic review

Evaluation of the Implementation of a Mobile Health Application to Support Dutch Primary Care for Diabetes: A Qualitative Study (Preprint)

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