Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.
Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Appl Res Intellect Disabil. 2019 Jul;32(4):913-931. doi: 10.1111/jar.12583. Epub 2019 Apr 5.
Due to complex processes of implementation of innovations aimed at persons with intellectual disabilities in healthcare organizations, lifestyle interventions are not used as intended or not used at all. In order to provide insight into determinants influencing this implementation, this study aims to ascertain if the Measurement Instrument for Determinants of Innovations (MIDI) is useful for objectively evaluating implementation.
With semi-structured interviews, data concerning determinants of implementation of lifestyle interventions were aggregated. These data were compared to the determinants questioned in the MIDI. Adaptations to the MIDI were made in consultation with the author of the MIDI.
All determinants of the MIDI, except for that concerning legislation and regulations, were represented in the interview data. Determinants not represented in the MIDI were the level of intellectual disabilities, suitability of materials and physical environment, multi-levelness of interventions and several persons who could be involved in the intervention, such as direct support persons (DSPs), a therapist or family, and the communication between these involved persons.
The present authors suggested making adjustments to existing questions of the MIDI in order to improve usability for deployment in organizations that provide care to persons with intellectual disabilities. The adjustments need to be tested with other interventions.
由于在医疗保健组织中实施针对智力残疾人士的创新举措涉及复杂的过程，生活方式干预措施并未按预期实施，或者根本未被采用。为了深入了解影响实施的决定因素，本研究旨在确定衡量创新决定因素的工具（MIDI）是否有助于客观评估实施情况。
通过半结构化访谈，汇总了与生活方式干预措施实施相关的决定因素数据。将这些数据与 MIDI 中询问的决定因素进行比较。与 MIDI 的作者协商后，对 MIDI 进行了调整。
MIDI 的所有决定因素，除了法规方面，都在访谈数据中得到了体现。而 MIDI 中未涉及的决定因素包括智力残疾的程度、材料和物理环境的适宜性、干预措施的多层次性以及可能参与干预的多个人，如直接支持人员（DSP）、治疗师或家属，以及这些相关人员之间的沟通。
作者建议对 MIDI 中现有的问题进行调整，以提高其在为智力残疾人士提供护理的组织中的可用性。需要对其他干预措施进行调整测试。
