Pelletier Cynthia, Chabot Christian, Gagnon Marie-Pierre, Rhéaume Caroline
Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada.
VITAM - Centre de recherche en santé durable, Université Laval, Québec, QC, Canada.
JMIR Form Res. 2023 Mar 10;7:e44254. doi: 10.2196/44254.
Many projects related to technology implementation in the context of chronic diseases have been developed over the years to better manage lifestyle medicine interventions and improve patient care. However, technology implementation in primary care settings remains challenging.
The aim is to carry out a strengths, weaknesses, opportunities, and threats (SWOT) analysis (1) to assess satisfaction among patients with type 2 diabetes using an activity tracker to increase motivation for physical activity (PA) and (2) to explore the research and health care team's perceptions of this technology's implementation in a primary care setting.
A 3-month hybrid type 1 study, which included 2 stages, was conducted in an academic primary health center in Quebec City, Quebec, Canada. In stage 1, a total of 30 patients with type 2 diabetes were randomized to the intervention (activity tracker) group or the control group. In stage 2, a SWOT analysis was performed on both patients and health care professionals to determine the components of successful technology implementation. Two questionnaires were used to gather feedback: a satisfaction and acceptability questionnaire concerning an activity tracker (15 patients in the intervention group) and a questionnaire based on the SWOT elements (15 patients in the intervention group and 7 health care professionals). Both questionnaires contained quantitative and qualitative questions. Qualitative variables from open questions were synthesized in a matrix and ranked according to apparition frequency and global importance. A thematic analysis was performed by the first author and validated by 2 coauthors separately. The information gathered was triangulated to propose recommendations that were then approved by the team. Both quantitative (randomized controlled trial participants) and qualitative (randomized controlled trial participants and team) results were combined for recommendations.
In total, 86% (12/14) of the participants were satisfied with their activity tracker use and 75% (9/12) felt that it incited them to stick to their PA program. The main strengths of the team members' perspectives were the project initiation and involvement of a patient partner, the study design, the team, and the device. The weaknesses were the budgetary constraints, the turnover, and the technical issues. The opportunities were the primary care setting, the loan of equipment, and common technology. The threats were recruitment issues, administrative challenges, technological difficulties, and a single research site.
Patients with type 2 diabetes were satisfied with their activity tracker used to improve motivation for PA. Health care team members agreed that implementation can be done in primary care, but some challenges remain in using this technological tool in clinical practice regularly.
ClinicalTrials.gov NCT03709966; https://clinicaltrials.gov/ct2/show/NCT03709966.
多年来，已经开展了许多与慢性病背景下的技术实施相关的项目，以更好地管理生活方式医学干预措施并改善患者护理。然而，在基层医疗环境中实施技术仍然具有挑战性。
旨在进行优势、劣势、机会和威胁（SWOT）分析，（1）评估使用活动追踪器的2型糖尿病患者的满意度，以提高身体活动（PA）的积极性；（2）探索研究和医疗团队对该技术在基层医疗环境中实施的看法。
在加拿大魁北克省魁北克市的一家学术性初级卫生中心进行了一项为期3个月的混合型1期研究，该研究包括两个阶段。在第1阶段，共有30名2型糖尿病患者被随机分为干预组（活动追踪器组）或对照组。在第2阶段，对患者和医疗保健专业人员进行了SWOT分析，以确定技术成功实施的组成部分。使用了两份问卷来收集反馈：一份关于活动追踪器的满意度和可接受性问卷（干预组中的15名患者）以及一份基于SWOT要素的问卷（干预组中的15名患者和7名医疗保健专业人员）。两份问卷都包含定量和定性问题。来自开放式问题的定性变量在一个矩阵中进行综合，并根据出现频率和总体重要性进行排名。第一作者进行了主题分析，并分别由2名共同作者进行了验证。收集到的信息进行了三角测量，以提出建议，然后由团队批准。定量（随机对照试验参与者）和定性（随机对照试验参与者和团队）结果相结合以提出建议。
总体而言，86%（12/14）的参与者对他们使用活动追踪器感到满意，75%（9/12）的人认为它促使他们坚持PA计划。团队成员观点的主要优势在于项目的启动以及患者合作伙伴的参与、研究设计、团队和设备。劣势在于预算限制、人员流动和技术问题。机会在于基层医疗环境、设备借用和通用技术。威胁在于招募问题、行政挑战、技术困难和单一研究地点。
2型糖尿病患者对用于提高PA积极性的活动追踪器感到满意。医疗团队成员一致认为可以在基层医疗中实施，但在临床实践中定期使用这种技术工具仍存在一些挑战。
ClinicalTrials.gov NCT03709966；https://clinicaltrials.gov/ct2/show/NCT03709966。
