Patricia is a PhD student at University Medical Center Utrecht in the Netherlands. Her project is focusing on the implementation of a combined lifestyle intervention, ProMuscle, for community dwelling older adults.
With more than 10 years’ experience as a physical therapist in geriatric care, a need for improving health care especially for the older adults grew more and more. Therefore, Patricia started the master Clinical Heath Sciences at the University of Utrecht and obtained her master’s degree in 2020.
Research interest include implementation, prevention, and health care for older adults.
ProMuscle is a combined lifestyle intervention that has shown to be effective in improving muscle mass, muscle strength, and physical functioning in community-dwelling older adults. Potentially, it could facilitate older people in maintaining their functional independence.
To increase the likelihood of successful implementation of ProMuscle, this study aims to develop appropriate implementation strategies targeting previously identified barriers to implement ProMuscle in community-care.
A theory-informed approach was adopted to develop appropriate implementation strategies, consisting of four subsequent steps. First, previously identified barriers for implementation were categorized into the constructs of the Consolidated Framework for Implementation Research (CFIR), including the underlying theoretical constructs. Second, the CFIR-ERIC matching Tool linked barriers to implementation strategies. Behavioral change strategies were added from literature. Third, evidence for implementation strategies was sought in literature. Fourth, in co-creation with involved healthcare professionals and implementation experts, implementation strategies were operationalized to practical implementation activities following the guidance of Proctor. Lastly, an implementation plan that can be tailored to individuals’ context was developed, prioritizing implementation activities over time.
A total of 654 barriers were categorized to the CFIR framework. The majority of barriers were related to the CFIR domain outer setting. Subsequently, the identified barriers were linked to 37 unique strategies. As many strategies affected multiple barriers, strategies were assigned in eight overarching themes: assessing the context, network internally, network externally, costs, education, process, champions, content of the intervention, and behavioral change of the end-users.
Co-creation sessions with professionals and implementation-experts resulted in tangible implementation actions, processed into an online implementation toolbox that supports healthcare professionals chronologically during the implementation process.
The theory-informed approach in combination with co-creation led to the development of practical multicomponent implementation strategies to implement ProMuscle. Next step is to evaluate the implementation strategies including the implementation toolbox regarding the implementation of ProMuscle in community-care.