Having trained as a master’s in Health Sciences and Human Movement Sciences at the VU University Amsterdam in the Netherlands, Evelien is currently undertaking a PhD at the Leiden University Medical Center. The focus of her PhD concerns the prevention of psychosocial problems within youth care. She has an interest in the implementation processes and uses several methods in her research. Currently, in addition to her PhD trajectory, she is involved in a research project on the (cost-)effectiveness of Social Prescribing, where she performs a systematic review to identify key characteristics of Social Prescribing interventions.
The implementation of evidence-based youth care guidelines remains a complex process. Several frameworks to aid the identification and specification of implementation determinants and effective strategies have been developed [1-4]. However, how specific determinants are influenced by specific strategies is not yet clear. There is a need for clarity on which active ingredients of strategies, called Behavior Change Techniques (BCTs) , elicit behavior change, and in turn, implementation outcomes. With this knowledge, we are able to formulated detailed, evidence-based implementation hypotheses. We aimed to identify 1) relevant determinants to the implementation of youth care guidelines and 2) feasible and effective implementation hypotheses to address these determinants.
A four-round online Delphi study was conducted. In the first round, experts rated determinants on their relevance. In the second, implementation hypotheses were formulated by connecting BCTs and implementation strategies to determinants. In round three, experts reconsidered and finalized their hypotheses based on an anonymous overview of hypotheses formulated by all experts including their substantiations. Finally, experts were asked to rate the implementation hypotheses on potential effectiveness and feasibility.
Fourteen experts completed the first, second, and third round and twelve the final round. Promotion of guideline use, Mandatory education, Presence of an implementation leader, Poor management support, Knowledge regarding use of the guideline, and Lack of communication skills were reported as most relevant. For each determinant, an overview is provided of the implementation hypotheses most often considered as effective and feasible.
Determinants related to knowledge, skills, and engagement of professionals and management were found to be relevant for the implementation of youth care guidelines.. This study provides a set of hypotheses that could facilitate organizations, policy makers, and professionals to guide the implementation process of youth care guidelines to, ultimately, improve implementation outcomes. Their effectiveness in practice remains to be assessed.