Implementation barriers and facilitators for referral from the hospital to community-based lifestyle interventions from the perspective of lifestyle professionals: A qualitative study

Leonie M. te Loo; Jasmijn F. M. Holla; Joyce Vrijsen; Anouk Driessen; Marlinde L. van Dijk; Lilian Linders; Inge van den Akker-Scheek; Adrie Bouma; Leah Schans; Linda Schouten; Patrick Rijnbeek; Rienk Dekker; Martine de Bruijne; Hidde P. van der Ploeg; Willem van Mechelen; Judith G. M. Jelsma

doi:10.1371/journal.pone.0304053

journal article Open Access Jun 27, 2024

Implementation barriers and facilitators for referral from the hospital to community-based lifestyle interventions from the perspective of lifestyle professionals: A qualitative study

Leonie M. te Loo

Jasmijn F. M. Holla

Joyce Vrijsen Anouk Driessen Marlinde L. van Dijk Lilian Linders Inge van den Akker-Scheek Adrie Bouma Leah Schans Linda Schouten Patrick Rijnbeek Rienk Dekker Martine de Bruijne

Hidde P. van der Ploeg Willem van Mechelen Judith G. M. Jelsma

PLoS ONE Vol. 19 No. 6 pp. e0304053 · Public Library of Science (PLoS)

View at Publisher Save 10.1371/journal.pone.0304053

Abstract

Purpose
A lifestyle front office (LFO) in the hospital is a not yet existing, novel concept that can refer patients under treatment in the hospital to community-based lifestyle interventions (CBLI). The aim of this study was to identify implementation barriers and facilitators regarding the implementation of an LFO in the hospital from the perspective of CBLI-professionals and to develop evidence-based implementation strategies to reduce these identified barriers.

Methods
We conducted semi-structured interviews until data saturation, with 23 lifestyle professionals working in the community. A semi-structured topic guide was used, inquiring about (1) community-based lifestyle interventions; (2) their views about referral from the LFO; and (3) their preferences, needs and recommendations for collaboration with the LFO in the hospital. The online interviews lasted on average 46 minutes, were audio-recorded and transcribed verbatim. A thematic content analysis was conducted. Found barriers and facilitators regarding the LFO where mapped using the consolidated framework for implementation research (CFIR) whereafter evidence based strategies were developed using the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC).

Results
Barriers and facilitators were divided into two main themes: 1) barriers and facilitators related to the referral from LFO to CBLI (i.e. financial, cultural, geographical, quality) and 2) barriers and facilitators related to the collaboration between LFO and CBLI (i.e. referral, communication platform and partnership). Thirty-seven implementation strategies concerning 15 barriers were developed and clustered into six overarching strategies: identify referral options, determine qualifications lifestyle professionals, develop support tools, build networks, facilitate learning collaboratives, and optimize workflow.

Conclusions
In this study, barriers and facilitators for the development of the LFO were found and matching implementation strategies were developed. Practical improvements, like identifying specific referral options or develop support tools, can be implemented immediately. The implementation of other strategies, like connecting care pathways in basic services, primary, secondary and tertiary care, will take more time and effort to come to full potential. Future research should evaluate all implemented strategies.

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Details

Published: Jun 27, 2024
Vol/Issue: 19(6)
Pages: e0304053
License: View

Authors

Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands;; Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands;

Inge van den Akker-Scheek

Hidde P. van der Ploeg

Centre for Physical Activity and Health, School of Public Health, University of Sydney, Sydney, Australia

Funding

ZonMw Award: 555003208

COE: prevention in care and welfare; Inholland University of applied sciences

Cite This Article

Leonie M. te Loo, Jasmijn F. M. Holla, Joyce Vrijsen, et al. (2024). Implementation barriers and facilitators for referral from the hospital to community-based lifestyle interventions from the perspective of lifestyle professionals: A qualitative study. PLoS ONE, 19(6), e0304053. https://doi.org/10.1371/journal.pone.0304053

Implementation barriers and facilitators for referral from the hospital to community-based lifestyle interventions from the perspective of lifestyle professionals: A qualitative study

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