TY - JOUR
T1 - Factors influencing implementation of digital cardiac rehabilitation
T2 - A qualitative analysis of health workers perspectives
AU - Gibson, Irene
AU - Kerins, Claire
AU - Foley, Louise
AU - Hynes, Lisa
AU - Byrne, Molly
AU - Murphy, Andrew William
AU - Reardon, Caitlin Marie
AU - McEvoy, John William
AU - Meade, Oonagh
N1 - Publisher Copyright:
Copyright: © 2024 Gibson I et al.
PY - 2024
Y1 - 2024
N2 - Background: Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Methods: Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Results: Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). Conclusion: The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.
AB - Background: Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Methods: Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Results: Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). Conclusion: The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.
KW - Cardiovascular disease
KW - Consolidated Framework for Implementation Research
KW - cardiac rehabilitation
KW - digital health
KW - implementation science
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85206240786&partnerID=8YFLogxK
U2 - 10.12688/hrbopenres.13929.1
DO - 10.12688/hrbopenres.13929.1
M3 - Article
AN - SCOPUS:85206240786
SN - 2515-4826
VL - 7
JO - HRB Open Research
JF - HRB Open Research
M1 - 50
ER -