PDF(Pubmed)
Abstract：
BACKGROUND: The implementation of youth care guidelines remains a complex process. Several evidence-based frameworks aid the identification and specification of implementation determinants and strategies. However, the influence of specific strategies on certain determinants remains unclear. Therefore, we need to clarify which active ingredients of strategies, known as behaviour change techniques (BCTs), elicit behaviour change and improve implementation outcomes. With this knowledge, we are able to formulate evidence-based implementation hypotheses. An implementation hypothesis details how determinants and in turn, implementation outcomes might be influenced by specific implementation strategies and their BCTs. We aimed to identify (1) determinants relevant to the implementation of youth care guidelines and (2) feasible and potentially effective implementation hypotheses.
METHODS: A four-round online modified Delphi study was conducted. In the first round, experts rated the implementation determinants based on their relevance. Next, experts formulated implementation hypotheses by connecting BCTs and implementation strategies to determinants and were asked to provide a rationale for their choices. In round three, the experts reconsidered and finalised their hypotheses based on an anonymous overview of all formulated hypotheses, including rationales. Finally, the experts rated the implementation hypotheses based on their potential effectiveness and feasibility.
RESULTS: Fourteen experts completed the first, second, and third rounds, with 11 completed the final round. Guideline promotion, mandatory education, presence of an implementation leader, poor management support, knowledge regarding guideline use, and a lack of communication skills were reported as most relevant determinants. In total, 46 hypotheses were formulated, ranging from 6 to 9 per determinant. For each determinant, we provide an overview of the implementation hypotheses that were most commonly deemed feasible and potentially effective.
CONCLUSIONS: This study offers valuable insights into youth care guideline implementation by systematically identifying relevant determinants and formulating hypotheses based on expert input. Determinants related to engagement and to knowledge and skills were found to be relevant to youth care guideline implementation. This study offers a set of hypotheses that could help organisations, policymakers, and professionals guide the implementation process of youth care guidelines to ultimately improve implementation outcomes. The effectiveness of these hypotheses in practice remains to be assessed.
METHODS: A four-round online modified Delphi study was conducted. In the first round, experts rated the implementation determinants based on their relevance. Next, experts formulated implementation hypotheses by connecting BCTs and implementation strategies to determinants and were asked to provide a rationale for their choices. In round three, the experts reconsidered and finalised their hypotheses based on an anonymous overview of all formulated hypotheses, including rationales. Finally, the experts rated the implementation hypotheses based on their potential effectiveness and feasibility.
RESULTS: Fourteen experts completed the first, second, and third rounds, with 11 completed the final round. Guideline promotion, mandatory education, presence of an implementation leader, poor management support, knowledge regarding guideline use, and a lack of communication skills were reported as most relevant determinants. In total, 46 hypotheses were formulated, ranging from 6 to 9 per determinant. For each determinant, we provide an overview of the implementation hypotheses that were most commonly deemed feasible and potentially effective.
CONCLUSIONS: This study offers valuable insights into youth care guideline implementation by systematically identifying relevant determinants and formulating hypotheses based on expert input. Determinants related to engagement and to knowledge and skills were found to be relevant to youth care guideline implementation. This study offers a set of hypotheses that could help organisations, policymakers, and professionals guide the implementation process of youth care guidelines to ultimately improve implementation outcomes. The effectiveness of these hypotheses in practice remains to be assessed.
摘要：
背景：青少年护理指南的实施仍然是一个复杂的过程。几个基于证据的框架有助于确定和规范实施决定因素和策略。然而,具体策略对某些决定因素的影响尚不清楚.因此,我们需要澄清策略的哪些活性成分，被称为行为改变技术(BCT)，引发行为改变并改善实施结果。有了这些知识,我们能够制定基于证据的实施假设。实施假设详细说明了决定因素和反过来，实施结果可能会受到具体实施策略及其BCT的影响。我们旨在确定（1）与实施青年护理指南相关的决定因素，以及（2）可行且可能有效的实施假设。
方法：进行了四轮在线改良Delphi研究。在第一轮中，专家们根据实施决定因素的相关性对其进行了评级。接下来,专家们通过将BCT和实施策略与决定因素联系起来制定了实施假设，并被要求为他们的选择提供理由。在第三轮中，专家们根据对所有提出的假设的匿名概述，重新考虑并最终确定了他们的假设，包括理由。最后,专家们根据实施假设的潜在有效性和可行性对其进行了评估。
结果：14位专家完成了第一个，第二,第三轮，11人完成了最后一轮。指导推广，义务教育,执行负责人在场，管理支持不力，有关指南使用的知识，据报道，缺乏沟通技巧是最相关的决定因素。总的来说,提出了46个假设，每个行列式从6到9不等。对于每个行列式，我们提供了最通常被认为可行和潜在有效的实施假设的概述。
结论：本研究通过系统地确定相关决定因素并根据专家意见制定假设，为青年护理指南的实施提供了有价值的见解。发现与参与以及与知识和技能有关的决定因素与青年护理指南的实施有关。这项研究提供了一组假设，可以帮助组织，政策制定者，和专业人员指导青年护理指南的实施过程，以最终改善实施成果。这些假设在实践中的有效性仍有待评估。
方法：进行了四轮在线改良Delphi研究。在第一轮中，专家们根据实施决定因素的相关性对其进行了评级。接下来,专家们通过将BCT和实施策略与决定因素联系起来制定了实施假设，并被要求为他们的选择提供理由。在第三轮中，专家们根据对所有提出的假设的匿名概述，重新考虑并最终确定了他们的假设，包括理由。最后,专家们根据实施假设的潜在有效性和可行性对其进行了评估。
结果：14位专家完成了第一个，第二,第三轮，11人完成了最后一轮。指导推广，义务教育,执行负责人在场，管理支持不力，有关指南使用的知识，据报道，缺乏沟通技巧是最相关的决定因素。总的来说,提出了46个假设，每个行列式从6到9不等。对于每个行列式，我们提供了最通常被认为可行和潜在有效的实施假设的概述。
结论：本研究通过系统地确定相关决定因素并根据专家意见制定假设，为青年护理指南的实施提供了有价值的见解。发现与参与以及与知识和技能有关的决定因素与青年护理指南的实施有关。这项研究提供了一组假设，可以帮助组织，政策制定者，和专业人员指导青年护理指南的实施过程，以最终改善实施成果。这些假设在实践中的有效性仍有待评估。
