Implementation of a Self-Help Swallowing Exercise Program in Head and Neck Cancer

Area of Science:

• Oncology
• Rehabilitation Medicine
• Health Services Research

Background:

• Swallowing problems are common in head and neck cancer (HNC) patients undergoing (chemo)radiotherapy.
• Guided self-help exercise programs like Head Matters (HM) aim to mitigate these issues and support self-management.
• Evaluating the real-world adoption and implementation of such programs is crucial for patient care.

Purpose of the Study:

• To assess the adoption and implementation rates of the Head Matters (HM) program in Dutch HNC centers.
• To identify healthcare professionals' perceived barriers and facilitators influencing the sustainable use of HM.
• To understand factors affecting the integration of HM into routine HNC care.

Main Methods:

• A mixed-methods approach was employed across all 14 Dutch HNC centers.
• Quantitative data were gathered using the Measurement Instrument for Determinants of Innovations (MIDI) pre- and post-implementation.
• Qualitative data were collected through semi-structured interviews with multidisciplinary healthcare professionals.

Main Results:

• High adoption (93%) and implementation (85% of adopters) rates of HM were observed.
• Speech-language pathologists reported more positive perceptions of procedural clarity, completeness, and compatibility.
• Facilitators included intuitive design and accessibility; barriers involved digital literacy, login issues, and organizational visibility.

Conclusions:

• The Head Matters (HM) program demonstrated successful adoption and implementation in Dutch HNC centers.
• Local adaptation and designated coordinators were key factors in facilitating program uptake.
• Sustained implementation necessitates ongoing focus on training, organizational integration, and institutional visibility for swallowing exercise programs.