Anticipated barriers and facilitators of implementing a digital behavioral treatment for chronic pain: a qualitative interview study

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Abstract

Abstract Background In digital health innovations, sustainable implementation should be considered from the initiation of the development to ensure that the solution fits into the existing healthcare system. This study aims at identifying barriers and facilitators for the prospective implementation of a digital behavioral intervention for chronic pain in the Swedish healthcare system, as perceived by key stakeholders. Methods Eight semi-structured individual interviews were conducted with stakeholders (n = 2 IT developers, n = 4 healthcare managers, n = 2 healthcare professionals). Qualitative data were analyzed using a framework analysis following the Consolidated Framework for Implementation Research (CFIR). Results A total of 86 facilitators and 38 barriers to prospective implementation were identified across stakeholder interviews. Facilitators included perceived relevance of the digital intervention and organizational readiness. Identified barriers primarily related to insufficient training and supervision, unclear decision-making processes (e.g., specific actions, responsibilities of stakeholders), and the lack of systematic needs assessment to guide implementation planning. Conclusion Overall, findings indicate a high level of openness toward digital interventions within the implementation context. While implementation context largely demonstrates readiness, successful integration will depend on proactively addressing identified barriers. Awareness of these factors enhances the likelihood of successful and sustainable implementation.

Authors 11

1. Afra Selma Taygar

   Karolinska Institutet

   Affiliation as printed

   Karolinska Institute

2. Sara Laureen Bartels

   Karolinska Institutet · Maastricht University

   Affiliation as printed

   Karolinska Institute

   Maastricht University

3. Hannah Christie

   Royal College of Surgeons in Ireland

   Affiliation as printed

   Royal College of Surgeons in Ireland

4. Angeliki Pelika Aachen

   Leiden University

   Affiliation as printed

   Leiden University

5. Samira Hesse

   Tilburg University

   Affiliation as printed

   Tilburg University

6. Ida Katrina Flink

   Karolinska Institutet

   Affiliation as printed

   Karolinska Institute

7. Suzanne Petersson

   Linnaeus University · Karolinska Institutet

   Affiliation as printed

   Karolinska Institute

   Linnaeus University

8. Sophie I Johnsson

   Karolinska Institutet

   Affiliation as printed

   Karolinska Institute

9. Katja Boersma

   Örebro University

   Affiliation as printed

   Örebro University

10. Lance M. McCracken

    Uppsala University · Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

    Affiliation as printed

    Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

    Uppsala University

11. Rikard K. Wicksell

    Karolinska Institutet

    Affiliation as printed

    Karolinska Institute