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Implementation of a web-based national child health-care programme in a local context: A complex facilitator role
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0001-9870-8477
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0003-4312-2246
2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 20_suppl, p. 80-86, article id suppl. 20Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate child health-care coordinators’ experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. Methods: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. Results: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme ‘Being a facilitator: a complex role’ was formed to express the child health-care coordinators’ experiences. Conclusions: Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context. © 2018, © Author(s) 2018.

Place, publisher, year, edition, pages
SAGE Publications Ltd , 2018. Vol. 46, no 20_suppl, p. 80-86, article id suppl. 20
Keywords [en]
Child health care, decision support, facilitators, guidelines, ICT, implementation, child, human, infant, Internet, newborn, organization and management, preschool child, professional standard, psychology, public health, Sweden, Child Health Services, Child, Preschool, Humans, Infant, Newborn, National Health Programs, Professional Role
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:bth-16085DOI: 10.1177/1403494817744119ISI: 000428758300012Scopus ID: 2-s2.0-85044172782OAI: oai:DiVA.org:bth-16085DiVA, id: diva2:1195713
Conference
8th Nordic Health Promotion Research Conferences (NHPRC) on 20 Years of Health Promotion Research in the Nordic Countries - Health, Wellbeing and Physical Activity, Jyvaskyla, FINLAND, JUN 20-22, 2016
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2019-01-11Bibliographically approved
In thesis
1. Implementation and use of Web-based National Guidelines in Child Healthcare
Open this publication in new window or tab >>Implementation and use of Web-based National Guidelines in Child Healthcare
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In Sweden, child healthcare (CHC) is an important health promotion setting, providing universal and targeted interventions. High demands on child healthcare and the competences of CHC nurses, highlight the importance of access to supportive web-based guidelines in everyday work. The implementation of web-based guidelines is affected by various factors and can be challenging. The Swedish Rikshandbokenis national guidelines for CHC that are in the process of being implemented. The overall aim of this thesis was to investigate the CHC provided in Sweden before the implementation of the national CHC programme, and the implementation and usage of web-based national guidelines for CHC. Study Iaimed to investigate whether the Swedish CHC programme was equal and which methods for health surveillance the county councils offered. A web-survey distributed to CHC coordinators was used, and the data were analyzed with descriptive statistics. Study IIaimed to investigate how nurses in CHC use Rikshandboken and factors affecting its use. A web survey was used and analysed using descriptive and analytical statistics. Study IIIaimed to investigate CHC coordinators´ experiences of being a facilitator in the implementation of a new national CHC programme in the form of a web-based guide. Focus group interviews via Skype for Business were conducted and analyzed using qualitative content analysis. Study IVaimed to examine CHC nurses´ use and ways of understanding the national web-based guidelines, Rikshandboken. A mixed method with sequential explanatory design in two phases was used; a web-survey with descriptive statistics followed by telephone interviews with phenomenographic analysis. Study Vaimed to investigate the usage of the national web-based guidelines, Rikshandboken. The data were collected from Google Analytics, and analyzed using descriptive statistics. The results of the studies show that Rikshandbokenis widely used and that its usage has increased. CHC nurses are generally satisfied with the website and emphasizes the importance of national guidelines for CHC. Factors needed to be developed to improve Rikshandbokenwere suggested as well as prerequisites that are needed in the local context to use Rikshandbokenfully. It must be reliable, useful and relevant why the end users need to be involved in the development. With the right conditions, Rikshandbokencould be a resource for learning and a tool in everyday work for CHC nurses. The result also shows that the CHC is provided unequally, and that the CHC programme is challenging to implement in the local context. The CHC coordinators´ task is to facilitate the implementation of the web-based national guidelines; however, this responsibility is complex. Changing the content, structure and access to Rikshandbokenis not sufficient, in the local context, prerequisites for the use of these web-based national guidelines must exist, and only then can Rikshandbokenbe a contributing determinant to an equal CHC.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2019. p. 77
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 3
Keywords
Child healthcare, nurses, health promotion, information and communication technology, implementation, applied health technology
National Category
Engineering and Technology
Identifiers
urn:nbn:se:bth-17329 (URN)978-91-7295-363-5 (ISBN)
Public defence
2019-01-18, sal G340, Blekinge Tekniska Högskola, 371 79, Karlskrona, 14:00 (Swedish)
Opponent
Supervisors
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2019-04-02Bibliographically approved

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Tell, JohannaOlander, EwyAnderberg, PeterSanmartin Berglund, Johan

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