Factors influencing REducing Delay through edUcation on eXacerbations (REDUX) implementation: A stakeholder analysis

Clinical eHealth, vol. 8, pp. 17–25

Abstract

REducing Delay through edUcation on eXacerbations (REDUX) shows promise in reducing exacerbation recognition and action delays for chronic lung diseases in the Netherlands. However, factors influencing its successful implementation in China remain unclear. To identify the perceived factors influencing nurse-led self-management implementation of REDUX in China, stakeholder analysis using qualitative and quantitative approaches was conducted. A qualitative approach assessed support for REDUX, perceived influencing factors, and preferred intervention delivery mode among patients, healthcare professionals, and policymakers. A quantitative approach identified necessary conditions for developing and implementing a digital-version intervention, involving app developers and cyber-security officers. The study followed COREQ and stakeholder analysis guidelines. Thirty-five patients, healthcare professionals, and policymakers highly supported REDUX. Perceived influencing factors included facilitators (e.g., easy-to-use design, perceived benefits) and barriers (e.g., patients’ affordability, lack of policy support). Preferred intervention delivery modes varied among stakeholders. Eighty-seven app developers and cyber-security officers completed quantitative surveys. The quantitative data showed that the work process of developing the health apps and protecting the users’ security and privacy mostly aligned with the related international guideline recommendations. The study identified key interdependent factors that were perceived as crucial for REDUX implementation success. Healthcare policies should prioritize self-management intervention, and minor action plan adjustments are needed.

Authors 8

1. Xiaoyue Song corresponding Aachen Department of Public Health and Primary Care

   Leiden University Medical Center · Zhengzhou University

   Affiliation as printed

   Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   Faculty of Nursing and Health, Zhengzhou University, China

   National eHealth Living Lab (NeLL), 2300 RC Leiden, The Netherlands

2. Cynthia Hallensleben Aachen Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   National eHealth Living Lab (NeLL), 2300 RC Leiden, The Netherlands

3. Jun Xia Guo

   Fifth Affiliated Hospital of Zhengzhou University

   Affiliation as printed

   Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Zhengzhou University, China

4. Weihong Zhang

   Zhengzhou University

   Affiliation as printed

   Faculty of Nursing and Health, Zhengzhou University, China

5. Hongxia Shen Aachen Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   National eHealth Living Lab (NeLL), 2300 RC Leiden, The Netherlands

6. Robbert J. J. Gobbens

   University of Antwerp · Tilburg University · Inholland University of Applied Sciences

   Affiliation as printed

   Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp 2610 Antwerp, Belgium

   Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands

   Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands

7. Niels Henrik Chavannes Aachen Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   National eHealth Living Lab (NeLL), 2300 RC Leiden, The Netherlands

8. Anke Versluis Aachen Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   National eHealth Living Lab (NeLL), 2300 RC Leiden, The Netherlands