Walthouwer Michel Jean Louis, Oenema Anke, Soetens Katja, Lechner Lilian, de Vries Hein
School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands.
Department of Health Promotion, Maastricht University, PO Box 616, Maastricht 6200 MD, the Netherlands.
Health Promot Int. 2017 Oct 1;32(5):818-830. doi: 10.1093/heapro/daw014.
The aim of this qualitative study was to identify barriers and facilitators to the adoption and particularly the implementation of a web-based computer-tailored obesity prevention intervention by occupational health centers. Participants were directors of Dutch occupational health centers who had adopted and implemented the intervention for the corresponding efficacy study (n = 8) as well as non-adopters (n = 12). Individual semi-structured interviews were carried out to study barriers and facilitators related to the intervention, the user, the organization, and the socio-political environment. All interviews were carried out by telephone, audio-recorded and transcribed verbatim. The transcripts were analyzed using a directed-content approach and coded by two persons. There were important differences in perceptions between adopters and non-adopters, particularly on barriers and facilitators related to the intervention and the personal beliefs of the implementer. The relative advantages of the intervention were considered to be most important. Participants also indicated that their personal attitudinal and self-efficacy beliefs influenced their implementation efforts. Regarding the organization, the possibilities to increase profits and integrate the intervention within the organization were considered to be important facilitators for the implementation. Participants mentioned few implementation barriers and facilitators related to the socio-political environment. Strategies to improve the implementation of web-based computer-tailored interventions by occupational health centers should be tailored to implementers' unique perceptions and particularly address the perceived advantages and disadvantages of the intervention, attitudinal and self-efficacy beliefs, and the potential to increase organizations' profits and competitiveness.
这项定性研究的目的是确定职业健康中心采用并特别是实施基于网络的计算机定制肥胖预防干预措施的障碍和促进因素。参与者包括荷兰职业健康中心的主任，其中采用并实施了相应疗效研究干预措施的有8人，未采用的有12人。开展了个人半结构化访谈，以研究与干预措施、用户、组织以及社会政治环境相关的障碍和促进因素。所有访谈均通过电话进行，进行了录音并逐字转录。使用定向内容分析法对转录本进行分析，并由两人进行编码。采用者和未采用者之间在认知上存在重要差异，特别是在与干预措施和实施者个人信念相关的障碍和促进因素方面。干预措施的相对优势被认为是最重要的。参与者还表示，他们的个人态度和自我效能信念影响了他们的实施努力。关于组织，增加利润以及将干预措施整合到组织内部的可能性被认为是实施的重要促进因素。参与者提到与社会政治环境相关的实施障碍和促进因素很少。职业健康中心改善基于网络的计算机定制干预措施实施的策略应根据实施者的独特认知进行调整，尤其要解决干预措施的感知优缺点、态度和自我效能信念，以及增加组织利润和竞争力的潜力。
