Skip to main content
Top
Published in: Implementation Science 1/2009

Open Access 01-12-2009 | Methodology

Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context

Authors: Isabelle Vedel, Matthieu De Stampa, Howard Bergman, Joel Ankri, Bernard Cassou, François Blanchard, Liette Lapointe

Published in: Implementation Science | Issue 1/2009

Login to get access

Abstract

Background

In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention.

Methods

A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation.

Results

The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations.

Conclusion

This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the insight of healthcare professionalnd managers and emphasizes the need to intervene at different levels. Further research will be needed in order to develop a more thorough understanding of the impacts of such strategies on the final outcomes of intervention implementations.
Appendix
Available only for authorised users
Literature
1.
go back to reference Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003, 362 (9391): 1225-30. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003, 362 (9391): 1225-30. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed
2.
go back to reference Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed
3.
go back to reference Grimshaw JM, Thomas RE, Maclennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004, 8 (6): iii-iv. 1-72CrossRefPubMed Grimshaw JM, Thomas RE, Maclennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004, 8 (6): iii-iv. 1-72CrossRefPubMed
4.
go back to reference Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289: 1969-1975. 10.1001/jama.289.15.1969.CrossRefPubMed Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289: 1969-1975. 10.1001/jama.289.15.1969.CrossRefPubMed
5.
go back to reference Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer GS, Riccobono C, Schoenbaum SC, Schyve P, Shaw C: Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med Care. 2001, 39 (8 Suppl 2): II85-II92.PubMed Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer GS, Riccobono C, Schoenbaum SC, Schyve P, Shaw C: Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med Care. 2001, 39 (8 Suppl 2): II85-II92.PubMed
6.
go back to reference Berendsen AJ, Benneker WH, Meyboom-de Jong B, Klazinga NS, Schuling J: Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study. BMC Health Serv Res. 2007, 7: 4-10.1186/1472-6963-7-4.CrossRefPubMedPubMedCentral Berendsen AJ, Benneker WH, Meyboom-de Jong B, Klazinga NS, Schuling J: Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study. BMC Health Serv Res. 2007, 7: 4-10.1186/1472-6963-7-4.CrossRefPubMedPubMedCentral
7.
go back to reference Bates DW: Physicians and ambulatory electronic health records. Health Aff (Millwood). 2005, 24 (5): 1180-1189. 10.1377/hlthaff.24.5.1180.CrossRefPubMed Bates DW: Physicians and ambulatory electronic health records. Health Aff (Millwood). 2005, 24 (5): 1180-1189. 10.1377/hlthaff.24.5.1180.CrossRefPubMed
8.
go back to reference Mendelson D, Carino TV: Evidence-based medicine in the United States – de rigueur or dream deferred?. Health Aff . 2005, 24: 133-136. 10.1377/hlthaff.24.1.133.CrossRef Mendelson D, Carino TV: Evidence-based medicine in the United States – de rigueur or dream deferred?. Health Aff . 2005, 24: 133-136. 10.1377/hlthaff.24.1.133.CrossRef
9.
go back to reference Grol R: Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001, 39 (8 Suppl 2): II46-II54.PubMed Grol R: Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001, 39 (8 Suppl 2): II46-II54.PubMed
10.
go back to reference Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O'Brien MA: Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001, 39 (8 Suppl 2): II2-II45.PubMed Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O'Brien MA: Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001, 39 (8 Suppl 2): II2-II45.PubMed
11.
go back to reference Grol R, Grimshaw J: Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 1999, 25: 503-13.PubMed Grol R, Grimshaw J: Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 1999, 25: 503-13.PubMed
12.
go back to reference Shaw B, Cheater F, Baker R, Gillies C, Hearnshaw H, Flottorp S, Robertson N: Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2008, 20 (3): CD005470- Shaw B, Cheater F, Baker R, Gillies C, Hearnshaw H, Flottorp S, Robertson N: Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2008, 20 (3): CD005470-
13.
go back to reference Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ. 2000, 321: 694-6. 10.1136/bmj.321.7262.694.CrossRefPubMedPubMedCentral Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ. 2000, 321: 694-6. 10.1136/bmj.321.7262.694.CrossRefPubMedPubMedCentral
14.
go back to reference Medical Research Council: A framework for development and evaluation of RCTs for complex interventions to improve health. 2000, London: MRC, 18- Medical Research Council: A framework for development and evaluation of RCTs for complex interventions to improve health. 2000, London: MRC, 18-
16.
go back to reference Hagedorn H, Hogan M, Smith JL, Bowman C, Curran GM, Espadas D, Kimmel B, Kochevar L, Legro MW, Sales AE: Lessons learned about implementing research evidence into clinical practice. Experiences from VA QUERI. J Gen Intern Med. 2006, 21 (Suppl 2): S21-S24.PubMedPubMedCentral Hagedorn H, Hogan M, Smith JL, Bowman C, Curran GM, Espadas D, Kimmel B, Kochevar L, Legro MW, Sales AE: Lessons learned about implementing research evidence into clinical practice. Experiences from VA QUERI. J Gen Intern Med. 2006, 21 (Suppl 2): S21-S24.PubMedPubMedCentral
17.
go back to reference Ham C, Kipping R, McLeod H: Redesigning work processes in health care: lessons from the National Health Service. Milbank Q. 2003, 81: 415-439. 10.1111/1468-0009.t01-3-00062.CrossRefPubMedPubMedCentral Ham C, Kipping R, McLeod H: Redesigning work processes in health care: lessons from the National Health Service. Milbank Q. 2003, 81: 415-439. 10.1111/1468-0009.t01-3-00062.CrossRefPubMedPubMedCentral
18.
go back to reference Kochevar LK, Yano EM: Understanding health care organization needs and context. Beyond performance gaps. J Gen Intern Med. 2006, 21 Suppl 2: S25-S29.PubMed Kochevar LK, Yano EM: Understanding health care organization needs and context. Beyond performance gaps. J Gen Intern Med. 2006, 21 Suppl 2: S25-S29.PubMed
20.
go back to reference Bosch M, van der WT, Wensing M, Grol R: Tailoring quality improvement interventions to identified barriers: a multiple case analysis. J Eval Clin Pract. 2007, 13: 161-168. 10.1111/j.1365-2753.2006.00660.x.CrossRefPubMed Bosch M, van der WT, Wensing M, Grol R: Tailoring quality improvement interventions to identified barriers: a multiple case analysis. J Eval Clin Pract. 2007, 13: 161-168. 10.1111/j.1365-2753.2006.00660.x.CrossRefPubMed
21.
go back to reference Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral
22.
go back to reference Kirsh SR, Lawrence RH, Aron DC: Tailoring an intervention to the context and system redesign related to the intervention: A case study of implementing shared medical appointments for diabetes. Implementation Science. 2008, 3: 34-10.1186/1748-5908-3-34.CrossRefPubMedPubMedCentral Kirsh SR, Lawrence RH, Aron DC: Tailoring an intervention to the context and system redesign related to the intervention: A case study of implementing shared medical appointments for diabetes. Implementation Science. 2008, 3: 34-10.1186/1748-5908-3-34.CrossRefPubMedPubMedCentral
23.
go back to reference Mion L, Odegard PS, Resnick B, Segal-Galan F, Geriatrics Interdisciplinary Advisory Group AGS: Interdisciplinary care for older adults with complex needs: American Geriatrics Society position statement. J Am Geriatr Soc. 2006, 54: 849-852. 10.1111/j.1532-5415.2006.00707.x.CrossRefPubMed Mion L, Odegard PS, Resnick B, Segal-Galan F, Geriatrics Interdisciplinary Advisory Group AGS: Interdisciplinary care for older adults with complex needs: American Geriatrics Society position statement. J Am Geriatr Soc. 2006, 54: 849-852. 10.1111/j.1532-5415.2006.00707.x.CrossRefPubMed
24.
go back to reference Reuben DB: Organizational interventions to improve health outcomes of older persons. Med Care. 2002, 40: 416-428. 10.1097/00005650-200205000-00007.CrossRefPubMed Reuben DB: Organizational interventions to improve health outcomes of older persons. Med Care. 2002, 40: 416-428. 10.1097/00005650-200205000-00007.CrossRefPubMed
26.
go back to reference Wolff JL, Boult C: Moving beyond round pegs and square holes: restructuring Medicare to improve chronic care. Ann Intern Med. 2005, 143: 439-445.CrossRefPubMed Wolff JL, Boult C: Moving beyond round pegs and square holes: restructuring Medicare to improve chronic care. Ann Intern Med. 2005, 143: 439-445.CrossRefPubMed
27.
go back to reference Beland F, Bergman H, Lebel P, Clarfield AM, Tousignant P, Contandriopoulos AP, Dallaire L: A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2006, 61: 367-473.CrossRefPubMed Beland F, Bergman H, Lebel P, Clarfield AM, Tousignant P, Contandriopoulos AP, Dallaire L: A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2006, 61: 367-473.CrossRefPubMed
28.
go back to reference Wieland D, Lamb VL, Sutton SR, Boland R, Clark M, Friedman S, Brummel-Smith K, Eleazer GP: Hospitalization in the Program of All-Inclusive Care for the Elderly (PACE): rates, concomitants, and predictors. J Am Geriatr Soc. 2000, 48: 1373-1380.CrossRefPubMed Wieland D, Lamb VL, Sutton SR, Boland R, Clark M, Friedman S, Brummel-Smith K, Eleazer GP: Hospitalization in the Program of All-Inclusive Care for the Elderly (PACE): rates, concomitants, and predictors. J Am Geriatr Soc. 2000, 48: 1373-1380.CrossRefPubMed
29.
go back to reference Landi F, Onder G, Russo A, Tabaccanti S, Rollo R, Federici S, Tua E, Cesari M, Bernabei R: A new model of integrated home care for the elderly: impact on hospital use. J Clin Epidemiol. 2001, 54: 968-970. 10.1016/S0895-4356(01)00366-3.CrossRefPubMed Landi F, Onder G, Russo A, Tabaccanti S, Rollo R, Federici S, Tua E, Cesari M, Bernabei R: A new model of integrated home care for the elderly: impact on hospital use. J Clin Epidemiol. 2001, 54: 968-970. 10.1016/S0895-4356(01)00366-3.CrossRefPubMed
30.
go back to reference Johri M, Beland F, Bergman H: International experiments in integrated care for the elderly: a synthesis of the evidence. Int J Geriatr Psychiatry. 2003, 18 (3): 222-235. 10.1002/gps.819.CrossRefPubMed Johri M, Beland F, Bergman H: International experiments in integrated care for the elderly: a synthesis of the evidence. Int J Geriatr Psychiatry. 2003, 18 (3): 222-235. 10.1002/gps.819.CrossRefPubMed
31.
go back to reference Newcomer R, Harrington C, Kane R: Challenges and accomplishments of the second-generation social health maintenance organization. Gerontologist. 2002, 42: 843-852.CrossRefPubMed Newcomer R, Harrington C, Kane R: Challenges and accomplishments of the second-generation social health maintenance organization. Gerontologist. 2002, 42: 843-852.CrossRefPubMed
32.
go back to reference Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J, Ebrahim S: Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet. 2008, 371: 725-735. 10.1016/S0140-6736(08)60342-6.CrossRefPubMedPubMedCentral Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J, Ebrahim S: Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet. 2008, 371: 725-735. 10.1016/S0140-6736(08)60342-6.CrossRefPubMedPubMedCentral
33.
go back to reference Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, Williams D, Brummell K: Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ. 2001, 323: 719-725. 10.1136/bmj.323.7315.719.CrossRefPubMedPubMedCentral Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, Williams D, Brummell K: Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ. 2001, 323: 719-725. 10.1136/bmj.323.7315.719.CrossRefPubMedPubMedCentral
34.
go back to reference Kane RL, Homyak P, Bershadsky B, Lum YS: Consumer responses to the Wisconsin Partnership Program for Elderly Persons: a variation on the PACE Model. J Gerontol A Biol Sci Med Sci. 2002, 57 (4): M250-M258.CrossRefPubMed Kane RL, Homyak P, Bershadsky B, Lum YS: Consumer responses to the Wisconsin Partnership Program for Elderly Persons: a variation on the PACE Model. J Gerontol A Biol Sci Med Sci. 2002, 57 (4): M250-M258.CrossRefPubMed
35.
go back to reference Newcomer R, Harrington C, Kane R: Implementing the second generation social health maintenance organization. J Am Geriatr Soc. 2000, 48: 829-834.CrossRefPubMed Newcomer R, Harrington C, Kane R: Implementing the second generation social health maintenance organization. J Am Geriatr Soc. 2000, 48: 829-834.CrossRefPubMed
36.
go back to reference Pandit NR: The Creation of Theory: A Recent Application of the Grounded Theory Method. The Qualitative Report. 1996, 2: 1-20. Pandit NR: The Creation of Theory: A Recent Application of the Grounded Theory Method. The Qualitative Report. 1996, 2: 1-20.
37.
go back to reference Guba EG, Lincoln YS: Fourth Generation Evaluation. 1989, Newbury Park: Sage, 1 Guba EG, Lincoln YS: Fourth Generation Evaluation. 1989, Newbury Park: Sage, 1
38.
go back to reference Miles MB, Huberman M: Qualitative Data Analysis: An Expanded Sourcebook. 1994, Thousand Oaks: Sage, 2 Miles MB, Huberman M: Qualitative Data Analysis: An Expanded Sourcebook. 1994, Thousand Oaks: Sage, 2
39.
go back to reference Crabtree BF, Miller W: Doing Qualitative Research, Research Methods for Primary Care. 1992, Newbury Park: Sage, 3 Crabtree BF, Miller W: Doing Qualitative Research, Research Methods for Primary Care. 1992, Newbury Park: Sage, 3
40.
go back to reference Kennedy J: Unmet and undermet need for activities of daily living and instrumental activities of daily living assistance among adults with disabilities: estimates from the 1994 and 1995 disability follow-back surveys. Med Care. 2001, 39: 1305-1312. 10.1097/00005650-200112000-00006.CrossRefPubMed Kennedy J: Unmet and undermet need for activities of daily living and instrumental activities of daily living assistance among adults with disabilities: estimates from the 1994 and 1995 disability follow-back surveys. Med Care. 2001, 39: 1305-1312. 10.1097/00005650-200112000-00006.CrossRefPubMed
41.
go back to reference Sands LP, Wang Y, McCabe GP, Jennings K, Eng C, Covinsky KE: Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. J Am Geriatr Soc. 2006, 54: 339-344. 10.1111/j.1532-5415.2005.00590.x.CrossRefPubMed Sands LP, Wang Y, McCabe GP, Jennings K, Eng C, Covinsky KE: Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. J Am Geriatr Soc. 2006, 54: 339-344. 10.1111/j.1532-5415.2005.00590.x.CrossRefPubMed
42.
go back to reference Wenger NS, Solomon DH, Roth CP, MacLean CH, Saliba D, Kamberg CJ, Rubenstein LZ, Young RT, Sloss EM, Louie R, Adams J, Chang JT, Venus PJ, Schnelle JF, Shekelle PG: The quality of medical care provided to vulnerable community-dwelling older patients. Ann Intern Med. 2003, 139: 740-747.CrossRefPubMed Wenger NS, Solomon DH, Roth CP, MacLean CH, Saliba D, Kamberg CJ, Rubenstein LZ, Young RT, Sloss EM, Louie R, Adams J, Chang JT, Venus PJ, Schnelle JF, Shekelle PG: The quality of medical care provided to vulnerable community-dwelling older patients. Ann Intern Med. 2003, 139: 740-747.CrossRefPubMed
43.
go back to reference Kesselring A, Krulik T, Bichsel M, Minder C, Beck JC, Stuck AE: Emotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission. Eur J Public Health. 2001, 11: 267-273. 10.1093/eurpub/11.3.267.CrossRefPubMed Kesselring A, Krulik T, Bichsel M, Minder C, Beck JC, Stuck AE: Emotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission. Eur J Public Health. 2001, 11: 267-273. 10.1093/eurpub/11.3.267.CrossRefPubMed
44.
go back to reference Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW: Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007, 297: 831-841. 10.1001/jama.297.8.831.CrossRefPubMed Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW: Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007, 297: 831-841. 10.1001/jama.297.8.831.CrossRefPubMed
45.
go back to reference Flottorp S, Oxman A: Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods. BMC Health Serv Res. 2003, 3 (1): 3-10.1186/1472-6963-3-3.CrossRefPubMedPubMedCentral Flottorp S, Oxman A: Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods. BMC Health Serv Res. 2003, 3 (1): 3-10.1186/1472-6963-3-3.CrossRefPubMedPubMedCentral
46.
go back to reference Grol R, Buchan H: Clinical guidelines: what can we do to increase their use?. Med J Aust. 2006, 185: 301-302.PubMed Grol R, Buchan H: Clinical guidelines: what can we do to increase their use?. Med J Aust. 2006, 185: 301-302.PubMed
47.
go back to reference Gladman JR, Jones RG, Radford K, Walker E, Rothera I: Person-centred dementia services are feasible, but can they be sustained?. Age Ageing. 2007, 36: 171-176. 10.1093/ageing/afl161.CrossRefPubMed Gladman JR, Jones RG, Radford K, Walker E, Rothera I: Person-centred dementia services are feasible, but can they be sustained?. Age Ageing. 2007, 36: 171-176. 10.1093/ageing/afl161.CrossRefPubMed
48.
go back to reference Fuat A, Hungin AP, Murphy JJ: Barriers to accurate diagnosis and effective management of heart failure in primary care: qualitative study. BMJ. 2003, 326: 196-200. 10.1136/bmj.326.7382.196.CrossRefPubMedPubMedCentral Fuat A, Hungin AP, Murphy JJ: Barriers to accurate diagnosis and effective management of heart failure in primary care: qualitative study. BMJ. 2003, 326: 196-200. 10.1136/bmj.326.7382.196.CrossRefPubMedPubMedCentral
50.
go back to reference Heideman J, Laurant M, Verhaak P, Wensing M, Grol R: Effects of a nationwide programme: interventions to reduce perceived barriers to collaboration and to increase structural one-on-one contact. J Eval Clin Pract. 2007, 13: 860-866.PubMed Heideman J, Laurant M, Verhaak P, Wensing M, Grol R: Effects of a nationwide programme: interventions to reduce perceived barriers to collaboration and to increase structural one-on-one contact. J Eval Clin Pract. 2007, 13: 860-866.PubMed
51.
go back to reference Rogers EM: Diffusion of innovations. 1983, New-York: The Free Press, 3 Rogers EM: Diffusion of innovations. 1983, New-York: The Free Press, 3
52.
go back to reference Eisenhardt KM: Building Theories from Case Study Research. The Academy of Management Review. 1989, 14: 532-550. 10.2307/258557. Eisenhardt KM: Building Theories from Case Study Research. The Academy of Management Review. 1989, 14: 532-550. 10.2307/258557.
53.
go back to reference Boyer F, Novella JL, Morrone I, Jolly D, Blanchard F: Agreement between dementia patient report and proxy reports using the Nottingham Health Profile. Int J Geriatr Psychiatry. 2004, 19: 1026-34. 10.1002/gps.1191.CrossRefPubMed Boyer F, Novella JL, Morrone I, Jolly D, Blanchard F: Agreement between dementia patient report and proxy reports using the Nottingham Health Profile. Int J Geriatr Psychiatry. 2004, 19: 1026-34. 10.1002/gps.1191.CrossRefPubMed
54.
go back to reference Novella JL, Boyer F, Jochum C, Jovenin N, Morrone I, Jolly D, Bakchine S, Blanchard F: Health status in patients with Alzheimer's disease: an investigation of inter-rater agreement. Qual Life Res. 2006, 15: 811-9. 10.1007/s11136-005-5434-7.CrossRefPubMed Novella JL, Boyer F, Jochum C, Jovenin N, Morrone I, Jolly D, Bakchine S, Blanchard F: Health status in patients with Alzheimer's disease: an investigation of inter-rater agreement. Qual Life Res. 2006, 15: 811-9. 10.1007/s11136-005-5434-7.CrossRefPubMed
Metadata
Title
Healthcare professionals and managers' participation in developing an intervention: A pre-intervention study in the elderly care context
Authors
Isabelle Vedel
Matthieu De Stampa
Howard Bergman
Joel Ankri
Bernard Cassou
François Blanchard
Liette Lapointe
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2009
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-4-21

Other articles of this Issue 1/2009

Implementation Science 1/2009 Go to the issue