Identifying most important contextual factors for the implementation of self-management interventions: A Delphi study

Area of Science:

• Health Services Research
• Chronic Disease Management
• Implementation Science

Background:

• Successful implementation of self-management interventions (SMIs) for chronic conditions like type 2 diabetes, obesity, COPD, and heart failure is influenced by various contextual factors (CFs).
• A prior literature review identified 31 potential CFs across different levels that may impact SMI implementation.
• Reaching consensus on the most critical CFs is essential for effective adoption and integration of SMIs into clinical practice.

Approach:

• A three-round Delphi study was conducted with 44 stakeholders to identify and prioritize the most influential CFs for SMI implementation.
• Stakeholders scored, prioritized, and discussed the identified CFs, including any additional factors not present in the initial literature review.
• The study aimed to achieve consensus on the most significant CFs impacting the successful implementation of SMIs.

Key Points:

• The most important CFs demonstrated significant overlap across different components of SMIs and various chronic diseases.
• Stakeholders identified healthcare professionals' (HCPs) ability to adapt advice, communication, or interventions to the patient's specific situation and knowledge level as the most critical CF.
• Patient-related, HCP-related, and interaction-related factors were deemed most important by stakeholders.

Conclusions:

• Contextual factors must be carefully considered when implementing evidence-based SMIs.
• 'Tailoring' interventions to individual patient needs was highlighted as the most crucial aspect for HCPs.
• The identified CFs empower stakeholders to make informed decisions regarding the adoption of suitable SMIs within specific contexts, aiding in closing the research-to-practice gap.