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Facilitators and barriers to implementing lifestyle intervention programme to prevent cognitive decline
European Journal of Public Health ( IF 3.7 ) Pub Date : 2021-05-24 , DOI: 10.1093/eurpub/ckab087
Jenni Kulmala 1, 2, 3 , Anna Rosenberg 4 , Tiia Ngandu 2, 3 , Katri Hemiö 2 , Tarja Tenkula 5 , Arja Hyytiä 5 , Minna Vienola 6 , Minna Huhtamäki-Kuoppala 7 , Anneli Saarinen 8 , Saana Korkki 9 , Tiina Laatikainen 2, 10, 11 , Alina Solomon 4 , Miia Kivipelto 2, 3, 4, 12, 13, 14
Affiliation  

Background The Finnish Intervention Study to Prevent Cognitive Impairment and Disability is a randomized controlled trial that has tested the efficacy of a multidomain intervention targeting modifiable risk factors to prevent cognitive impairment/dementia. A combination of healthy diet, physical, social and cognitive activity, and management of cardiovascular risks was shown to be an effective model to promote brain health among older people. The aim of this qualitative study was to explore healthcare professionals’ perceptions of facilitators and barriers to implementing this lifestyle programme into health care. Methods Four semi-structured focus group interviews were conducted among healthcare professionals working in primary care and in non-governmental organizations (N=27). Participants were asked to discuss their perceptions of facilitators and barriers for implementing the multidomain intervention into clinical practice. Interviews were analyzed using content analysis. Results Barriers and facilitators described by the healthcare professionals were related to infrastructure and resources, client’s personal characteristics and the lifestyle intervention itself. These main categories included several sub-categories related to knowledge, motivation, resources, individualization and collaboration. The interviewees pointed out that more education on dementia prevention is needed, the work should be coordinated efficiently, resources to provide preventive health care should be adequate and multiprofessional collaboration is needed. Conclusions Transferring a lifestyle intervention from a trial-setting to real life requires knowledge about the factors that influence effective implementation. Identifying drivers and constraints of successful implementation helps to design and tailor future prevention programmes, increases motivation and adherence and supports system change.

中文翻译:

实施生活方式干预计划以防止认知能力下降的促进因素和障碍

背景芬兰预防认知障碍和残疾干预研究是一项随机对照试验,测试了针对可改变风险因素的多领域干预预防认知障碍/痴呆症的功效。健康饮食、身体、社交和认知活动以及心血管风险管理的结合被证明是促进老年人大脑健康的有效模式。这项定性研究的目的是探讨医疗保健专业人员对将这种生活方式计划实施到医疗保健中的促进因素和障碍的看法。方法 在初级保健和非政府组织工作的医疗保健专业人员中进行了四次半结构化焦点小组访谈(N=27)。参与者被要求讨论他们对在临床实践中实施多领域干预的促进因素和障碍的看法。访谈采用内容分析法进行分析。结果 医疗保健专业人员描述的障碍和促进因素与基础设施和资源、客户的个人特征和生活方式干预本身有关。这些主要类别包括与知识、动机、资源、个性化和协作相关的几个子类别。受访者指出,痴呆症的预防需要更多的教育,工作要有效协调,预防保健的资源要充足,需要多专业的合作。结论 将生活方式干预从试验环境转移到现实生活需要了解影响有效实施的因素。确定成功实施的驱动因素和制约因素有助于设计和调整未来的预防计划,提高动力和坚持,并支持系统变革。
更新日期:2021-05-24
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