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一项关于实施同伴辅导干预以改善职业医生预防性任务执行情况的混合方法过程评估。

A mixed methods process evaluation of the implementation of a peer coaching intervention to improve the execution of preventive tasks by occupational physicians.

作者信息

Orhan Pees S, van Oostrom S H, Schaafsma F G, Proper K I

机构信息

Centre for Prevention, Lifestyle and Health, Department Behaviour and Health, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands.

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

BMC Health Serv Res. 2025 May 30;25(1):776. doi: 10.1186/s12913-025-12950-z.

Abstract

OBJECTIVES

This study aimed to evaluate the process of implementation of a peer coaching intervention program for occupational physicians (OPs) to improve the execution of preventive tasks. Specifically, the evaluation seeks to: (1) describe the reach and uptake of the intervention program; (2) determine the extent to which the program was implemented as intended; (3) provide insights into experiences of OPs, and (4) identify factors influencing the implementation.

METHODS

This study employed a mixed-methods design. To address the four research aims, seven process indicators were used: acceptability, adoption, appropriateness, feasibility, fidelity, penetration and sustainability. Data were collected between March and June 2024 by means of an online questionnaire (N = 98), and 17 semi-structured interviews with group coordinators and OPs. The questionnaire included questions on attendance and reasons for non-attendance, experiences, and ratings of several aspects of the intervention program. Interviews focused on why and how OPs participated, experiences with the intervention program and how it can be improved, and how attention to prevention can be sustained.

RESULTS

Reach and uptake: 20 out of 21 groups allocated to the intervention program participated in the intervention and 98 out of 115 participants (85%) filled in the questionnaire. Three-quarters of the participants completed the entire program. Implementation as intended: 96% of the OPs successfully discussed barriers to the execution of preventive tasks, and 83% were able to formulate strategies for these barriers. Barriers and facilitators: Most participants managed to implement their formulated goals in practice. When they were unable to do so, time constraints and resistance from employers and their occupational health services often played a role. Participants' experiences: OPs valued the program's structure, interaction with colleagues, and the increased awareness it generated.

DISCUSSION AND CONCLUSION

The peer coaching group program was well-implemented and positively evaluated by OPs. The program can be improved by allocating more time to it, for instance by integrating it into the educational curriculum, and by paying more attention to the specific working conditions of OPs, such as the different sectors in which they are employed.

TRIAL REGISTRATION

ISRCTN registry; ISRCTN15394765. Registered on 27 June 2023.

摘要

目的

本研究旨在评估针对职业医师实施的同伴辅导干预项目的实施过程,以改善预防性任务的执行情况。具体而言,该评估旨在:(1)描述干预项目的覆盖范围和参与情况;(2)确定项目按预期实施的程度;(3)深入了解职业医师的体验;(4)识别影响实施的因素。

方法

本研究采用混合方法设计。为实现四个研究目标,使用了七个过程指标:可接受性、采用率、适宜性、可行性、保真度、渗透率和可持续性。2024年3月至6月期间,通过在线问卷(N = 98)以及对小组协调员和职业医师进行的17次半结构化访谈收集数据。问卷包括关于出勤情况和未出勤原因、体验以及对干预项目若干方面的评分等问题。访谈重点关注职业医师参与的原因和方式、对干预项目的体验以及如何改进该项目,以及如何维持对预防工作的关注。

结果

覆盖范围和参与情况:分配到干预项目的21个小组中有20个参与了干预,115名参与者中有98名(85%)填写了问卷。四分之三的参与者完成了整个项目。按预期实施:96%的职业医师成功讨论了执行预防性任务的障碍,83%的人能够针对这些障碍制定策略。障碍和促进因素:大多数参与者在实践中成功实现了他们制定的目标。当他们无法做到时,时间限制以及雇主及其职业健康服务部门的阻力往往起到了作用。参与者的体验:职业医师重视该项目的结构、与同事的互动以及它所带来的意识提升。

讨论与结论

同伴辅导小组项目实施良好,并得到职业医师的积极评价。可以通过为其分配更多时间来改进该项目,例如将其纳入教育课程,并更多地关注职业医师的具体工作条件,比如他们所从事的不同行业。

试验注册

ISRCTN注册库;ISRCTN15394765。于2023年6月27日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66dc/12123882/8a5474f15a8d/12913_2025_12950_Fig1_HTML.jpg

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