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Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory.
BMC Fam Pract. 2010 Aug 23; 11:60.BF

Abstract

BACKGROUND

Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden.

METHODS

A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption.

RESULTS

The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process.

CONCLUSION

When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the innovation to be implemented, and of its potential compatibility with existing routines. Regarding context, we suggest that implementation concurrent with other major organizational changes should be avoided. The choice of implementation strategy should be given thorough consideration.

Authors+Show Affiliations

Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. siw.carlfjord@liu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20731817

Citation

Carlfjord, Siw, et al. "Key Factors Influencing Adoption of an Innovation in Primary Health Care: a Qualitative Study Based On Implementation Theory." BMC Family Practice, vol. 11, 2010, p. 60.
Carlfjord S, Lindberg M, Bendtsen P, et al. Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory. BMC Fam Pract. 2010;11:60.
Carlfjord, S., Lindberg, M., Bendtsen, P., Nilsen, P., & Andersson, A. (2010). Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory. BMC Family Practice, 11, 60. https://doi.org/10.1186/1471-2296-11-60
Carlfjord S, et al. Key Factors Influencing Adoption of an Innovation in Primary Health Care: a Qualitative Study Based On Implementation Theory. BMC Fam Pract. 2010 Aug 23;11:60. PubMed PMID: 20731817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory. AU - Carlfjord,Siw, AU - Lindberg,Malou, AU - Bendtsen,Preben, AU - Nilsen,Per, AU - Andersson,Agneta, Y1 - 2010/08/23/ PY - 2010/05/05/received PY - 2010/08/23/accepted PY - 2010/8/25/entrez PY - 2010/8/25/pubmed PY - 2010/10/22/medline SP - 60 EP - 60 JF - BMC family practice JO - BMC Fam Pract VL - 11 N2 - BACKGROUND: Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden. METHODS: A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption. RESULTS: The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process. CONCLUSION: When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the innovation to be implemented, and of its potential compatibility with existing routines. Regarding context, we suggest that implementation concurrent with other major organizational changes should be avoided. The choice of implementation strategy should be given thorough consideration. SN - 1471-2296 UR - https://www.unboundmedicine.com/medline/citation/20731817/Key_factors_influencing_adoption_of_an_innovation_in_primary_health_care:_a_qualitative_study_based_on_implementation_theory_ L2 - https://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-11-60 DB - PRIME DP - Unbound Medicine ER -