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Abstract：
Streptococcus suis (S. suis) infections in weaned pigs are common and responsible for a high consumption of antimicrobials, and their presence is assumed to be multi-factorial. A specific evidence-based veterinary guideline to support the control of S. suis in weaned pigs was developed for veterinary practitioners in the Netherlands in 2014. Adherence to the S. suis clinical practice guideline helps veterinary practitioners to prevent and control the disease in a systematical approach and thereby improve antimicrobial stewardship and contribute to the prevention of antimicrobial resistance in animals and humans. The impact of such a clinical practice guideline on (animal) disease management depends not only on its content, but also largely on the extent to which practitioners adhere to the clinical guideline in practice. When the S. suis guideline was published, no specific activities were undertaken to support veterinarians\' uptake and implementation, thereby contributing to suboptimal adherence in clinical practice. As the S. suis guideline was comprehensively written by veterinary experts following an evidence-based approach, our aim was not to judge the (scientific) quality of the guideline but to study the possibility to improve the currently low adherence of this guideline in veterinary practice. This paper describes the systematic development, using Implementation Mapping, of a theory-based intervention program to support swine veterinarians\' adherence to the S. suis guideline. The knowledge, skills, beliefs about capabilities, and beliefs about consequences domains are addressed in the program, which includes seven evidence-based methods (modelling, tailoring, feedback, discussion, persuasive communication, active learning, and self-monitoring) for use in program activities such as a peer-learning meeting and an e-learning module. The intervention program has been developed for practicing swine veterinarians, lasts eight months, and is evaluated through a stepped-wedge design. The Implementation Mapping approach ensured that all relevant adopters and implementers were involved, and that outcomes, determinants (influencing factors), and objectives were systematically discussed.
摘要：
猪链球菌（S.猪）断奶猪的感染很常见，并且是高消耗抗菌药物的原因，它们的存在被认为是多因素的。2014年，为荷兰的兽医从业者制定了一项基于证据的兽医指南，以支持断奶猪中猪链球菌的控制。坚持猪链球菌临床实践指南有助于兽医从业人员以系统的方法预防和控制疾病，从而改善抗菌药物管理，并有助于预防动物和人类的抗菌素耐药性。这种临床实践指南对（动物）疾病管理的影响不仅取决于其内容，而且很大程度上取决于从业者在实践中遵守临床指南的程度。当S.suis指南发布时，没有开展具体活动来支持兽医的吸收和实施，从而导致临床实践中依从性欠佳。由于S.suis指南是由兽医专家按照循证方法全面编写的，我们的目的不是判断指南的(科学)质量,而是研究在兽医实践中提高指南目前低依从性的可能性.本文描述了系统的发展，使用实施映射，基于理论的干预计划，以支持猪兽医遵守猪链球菌指南。知识,技能,关于能力的信念，关于后果领域的信念在程序中得到解决，其中包括七个基于证据的方法(建模，剪裁,反馈,讨论,有说服力的沟通,主动学习,和自我监控）用于程序活动，例如同伴学习会议和电子学习模块。该干预计划已开发用于执业猪兽医，持续八个月,并通过阶梯式楔形设计进行评估。实施映射方法确保所有相关采用者和实施者都参与其中，而这些结果，决定因素(影响因素)，和目标进行了系统的讨论。
