Implementation of a complex eHealth intervention by a public–private partnership in clinical practice: a qualitative multicentre analysis using CFIR

Health Education Research, vol. 40

Abstract

Complex eHealth interventions-featuring multiple components within dynamic systems-are used for healthcare improvement. Public-private partnerships (PPPs), combining resources, expertise, and technology, are crucial in this context. Yet, integrating these interventions into practice remains challenging. This study identifies barriers and facilitators affecting implementation of the BENEFIT programme, a complex eHealth intervention targeting cardiovascular disease patients, by PPP within practice. A qualitative study design was employed. Ten key stakeholders from four cardiac rehabilitation (CR) sites, who were all PPP partners involved in developing and implementing the BENEFIT programme, were interviewed semistructured. Transcripts were analysed using Consolidated Framework for Implementation Research. Facilitators included programme adaptability, communication and planning within teams, digital healthcare needs, dedicated PPP leadership, PPP meeting structure and PPP's ability to quickly modify the implementation strategy. Barriers involved specific PPP challenges (frequently changing roles, unclear roles and responsibilities and limited staffing), workplace disruptions, poor information technology (IT) integration, and ambiguous implementation goals amongst CR sites. This case study highlights challenges in implementing complex eHealth interventions by PPPs within practice. The findings underscore the need for a comprehensive implementation approach considering specific PPP dynamics, including combined expertise and resources, transparent role definition, sufficient staffing, clear goal communication and adaptable strategies for sustainable implementation.

Authors 7

1. Renée V H IJzerman corresponding Aachen Institute of Psychology, Health Medical and Neuropsychology Unit

   Leiden University · Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Cardiology, Amsterdam UMC, University of Amsterdam , Meibergdreef 9, Amsterdam 1105 AZ,

   Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit , Wassenaarseweg 52, Leiden 2333 AK,

2. Rosalie van der Vaart Aachen Institute of Psychology, Health Medical and Neuropsychology Unit

   Leiden University · The Hague University of Applied Sciences

   Affiliation as printed

   Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit , Wassenaarseweg 52, Leiden 2333 AK,

   The Hague University of Applied Sciences, Centre of Expertise Health Innovation , Johanna Westerdijkplein 75, Den Haag 2521 EN,

3. Linda D. Breeman Aachen Institute of Psychology, Health Medical and Neuropsychology Unit

   Leiden University

   Affiliation as printed

   Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit , Wassenaarseweg 52, Leiden 2333 AK,

4. Roderik A. Kraaijenhagen
   Affiliation as printed

   NDDO Institute for Prevention and Early Diagnostics (NIPED) , Teleportboulevard 140, Amsterdam 1043 BZ,

   Vital10 , Courbetstraat 34, Amsterdam 1077 ZV,

5. Andrea W.M. Evers Aachen Institute of Psychology, Health Medical and Neuropsychology Unit Medical Delta

   Leiden University · Medical Delta · Erasmus University Rotterdam · Delft University of Technology

   Affiliation as printed

   Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit , Wassenaarseweg 52, Leiden 2333 AK,

   Medical Delta, Leiden University, Technical University Delft, Erasmus University Rotterdam , Huismansingel 4, Delft 2629 JH,

6. Wilma J.M. Scholte op Reimer

   University of Applied Sciences Utrecht · Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Cardiology, Amsterdam UMC, University of Amsterdam , Meibergdreef 9, Amsterdam 1105 AZ,

   HU University of Applied Sciences, Research Group Chronic Diseases , Heidelberglaan 7, Utrecht 3584 CH,

7. Veronica R. Janssen Aachen Department of Cardiology

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Centre, Department of Cardiology , Albinusdreef 2, Leiden 2333 ZA,