Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize): a qualitative study

W. H. Heideman, F. C. Rongen, C. Bolleurs, E. Govers, W. Kroeze, I. H.M. Steenhuis

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize.

METHODS: Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach.

RESULTS: According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy.

CONCLUSIONS: Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.

LanguageEnglish
Pages338-348
Number of pages11
JournalJournal of Human Nutrition and Dietetics
Volume32
Issue number3
Early online date20 Mar 2019
DOIs
Publication statusE-pub ahead of print - 20 Mar 2019

Fingerprint

Nutritionists
Weight Loss
Health Literacy
Counseling
Cooking
Interviews
Secondary Prevention
Health Status
Weight Reduction Programs
Organizational Innovation
Social Support
Obesity
Organizations
Health

Bibliographical note

© 2019 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Keywords

  • implementation
  • multi-component intervention
  • qualitative
  • SMARTsize
  • weight loss

Cite this

@article{b9684e415fe142ca80ca346a71a1a08c,
title = "Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize): a qualitative study",
abstract = "BACKGROUND: Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize.METHODS: Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach.RESULTS: According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy.CONCLUSIONS: Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.",
keywords = "implementation, multi-component intervention, qualitative, SMARTsize, weight loss",
author = "Heideman, {W. H.} and Rongen, {F. C.} and C. Bolleurs and E. Govers and W. Kroeze and Steenhuis, {I. H.M.}",
note = "{\circledC} 2019 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.",
year = "2019",
month = "3",
day = "20",
doi = "10.1111/jhn.12641",
language = "English",
volume = "32",
pages = "338--348",
journal = "Journal of Human Nutrition and Dietetics",
issn = "0952-3871",
publisher = "Wiley-Blackwell",
number = "3",

}

Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize) : a qualitative study. / Heideman, W. H.; Rongen, F. C.; Bolleurs, C.; Govers, E.; Kroeze, W.; Steenhuis, I. H.M.

In: Journal of Human Nutrition and Dietetics, Vol. 32, No. 3, 01.06.2019, p. 338-348.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize)

T2 - Journal of Human Nutrition and Dietetics

AU - Heideman, W. H.

AU - Rongen, F. C.

AU - Bolleurs, C.

AU - Govers, E.

AU - Kroeze, W.

AU - Steenhuis, I. H.M.

N1 - © 2019 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

PY - 2019/3/20

Y1 - 2019/3/20

N2 - BACKGROUND: Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize.METHODS: Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach.RESULTS: According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy.CONCLUSIONS: Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.

AB - BACKGROUND: Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize.METHODS: Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach.RESULTS: According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy.CONCLUSIONS: Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.

KW - implementation

KW - multi-component intervention

KW - qualitative

KW - SMARTsize

KW - weight loss

UR - http://www.scopus.com/inward/record.url?scp=85064435868&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064435868&partnerID=8YFLogxK

U2 - 10.1111/jhn.12641

DO - 10.1111/jhn.12641

M3 - Article

VL - 32

SP - 338

EP - 348

JO - Journal of Human Nutrition and Dietetics

JF - Journal of Human Nutrition and Dietetics

SN - 0952-3871

IS - 3

ER -