Implementation of the ‘BeweegKuur’ in practice: utilization of care of a lifestyle intervention in the Netherlands

Abstract

This study investigates the delivered care in a multidisciplinary lifestyle intervention by dieticians and physiotherapists compared to the protocol of this intervention. Participants with a body mass index (BMI) between 25 and 40 kg m 22 were divided over three different programs depending on their BMI and comorbidities. All these programs consisted of individual and group sessions with the dietician, while care by the physiotherapist differed by program. The dieticians and physiotherapists of 30 locations were contacted to provide data about health care use within the intervention from their health records. Data of 379 participants were available and showed that group sessions by dieticians were often not attended. Care by the physiotherapist was delivered according to the protocol to a larger extent. An average of 43 -93% of the sessions was attended. The level of attendance is comparable to other interventions, but especially attendance at group sessions with dieticians should be improved.

The implementation and sustainability of a combined lifestyle intervention in primary care: mixed method process evaluation

“…A study that also concerned a CLI found no effects on objectively measured health behaviors, and authors argued the disadvantage of targeting multiple lifestyle behaviors simultaneously [ 31 ]. In a study evaluating implementation in a small amount of ‘BeweegKuur’ HCCs, it had already been observed that guidance by a dietician was not performed according to protocol [ 32 ]. Some dieticians indicated that the timing of meetings and their content were possible reasons for non-adherence [ 32 ].…”

“…In a study evaluating implementation in a small amount of ‘BeweegKuur’ HCCs, it had already been observed that guidance by a dietician was not performed according to protocol [ 32 ]. Some dieticians indicated that the timing of meetings and their content were possible reasons for non-adherence [ 32 ]. The selective rejection of an intervention might have benefits, for instance in terms of feasibility or participant adherence, and is therefore not necessarily undesirable [ 33 ].…”

Prevention and treatment of obesity

“…It is not only the effectiveness of CLIs which has been studied, but the implementation process of CLIs in real-world settings has also been investigated [35,53,[70][71][72][73]. These process evaluations have identified implementation barriers in terms of a lack of multidisciplinary collaboration and insufficient skills among primary care professionals, as well as lack of time to optimise coaching [35,72].…”

“…The implementation process of various types of CLI has been evaluated [35,53,67,[70][71][72][73]158]. The results of many studies show too little multidisciplinary collaboration between important stakeholders, and professionals having insufficient skills and time to give participants the best possible guidance [35,72,159,160].…”

Measurement and promotion of physical activity

“…A study that also concerned a CLI found no effects on objectively measured health behaviours, and authors argued the disadvantage of targeting multiple lifestyle behaviours simultaneously (158). In a study evaluating implementation in a small amount of BeweegKuur HCCs, it had already been observed that guidance by a dietician was not performed according to protocol (159). Some dieticians indicated that the timing of meetings and their content were possible reasons for non -adherence (159).…”