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. 2017 Aug 15;17(1):562.
doi: 10.1186/s12913-017-2499-2.

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey

Theo J M Kuunders  1   2 , Monique A M Jacobs  3   4 , Ien A M van de Goor  3 , Marja J H van Bon-Martens  3   5 , Hans A M van Oers  3   6 , Theo G W M Paulussen  7
Affiliations

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey

Theo J M Kuunders et al. BMC Health Serv Res. .

Abstract

Background: Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study explores the determinants of guideline use by regional Dutch health professionals.

Methods: A web survey was send to 304 RHS health professionals. The questionnaire was based on a theory- and research-based framework of determinants of public health innovations. Main outcomes were guideline use and completeness of use, defined as the number of health topics and checklists used. Associations between determinants and (completeness of) guideline use were explored by multivariate regression models.

Results: The survey was started by 120 professionals (39%). Finally, results from 73 respondents (24%) were eligible for analyses. All 28 Dutch RHS organizations were represented in the final dataset. About half of the respondents (48%) used the guideline. The average score for completeness of use (potential range 1-10) was 2.37 (sd = 1.78; range 1-7). Knowledge, perceived task responsibility and usability were significantly related to guideline use in univariate analyses. Only usability remained significant in the multivariate model on guideline use. Only self-efficacy accounted for significant proportions of variance in completeness of use.

Conclusions: The results imply that strategies to improve guideline use by RHSs should primarily target perceived usability. Self-efficacy appeared the primary target for improving completeness of guideline use. Methods for targeting these determinants in RHSs are discussed.

Keywords: Guideline use; Implementation determinants; Implementation strategy; Local health policy; Regional health service; The Netherlands; Web based survey.

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Conflict of interest statement

Authors’ information

Theo J.M. Kuunders works as a researcher and science practitioner for the Department Tranzo, Scientific Center for Care and Welfare, Tilburg University. As a policy officer for a Regional Health Service, he is specialized in network policy development for RHS, municipalities and primary healthcare. His current research activities concern the implementation of national guidelines on health promotion at the local level.

Monique A.M. Jacobs - van der Bruggen (PhD) is an epidemiologist at the RHS ‘GGD Hart voor Brabant’ and works as a science practitioner at the Department Tranzo, Scientific Center for Care and Welfare, Tilburg University. From 2005 to 2010 most of her research focused on (cost) effectiveness of diabetes prevention. In 2010 she finished her thesis: Opportunities for diabetes prevention. She is currently involved in the evaluation of overweight prevention projects for children and monitoring of new tasks for municipalities in youth care.

Ien A.M. van de Goor is professor of Public Health at Tilburg University. She is senior researcher and program leader for the “Effectiveness of Individual Prevention-program.” She has expertise in initiating and supervising research projects in healthcare and welfare. She is specialized in studying prevention and lifestyle interventions, needs for care and support in clients and patients; evaluation research of health care and health promotion interventions; and studies in addiction, addiction care and treatment.

Marja J.H. van Bon-Martens (PhD), epidemiologist, works as senior scientific staff member at the Trimbos Institute, Netherlands Institute of Mental Health and Addiction, and as senior researcher at the Department Tranzo, Scientific Center for Care and Welfare, Tilburg University. She has wide managerial expertise in bringing evidence into policy and practice through implementation of epidemiological research, and in supporting health policy making.

Hans A.M. van Oers (Professor) is trained as a public health epidemiologist. Currently he is Chief Science Officer of System Assessment for Policy Support at the Dutch National Institute of Public Health and the Environment, and professor of Public Health at Tilburg University. His main research interests are in the field of public health epidemiology and public health policy making.

Theo G.W.M. Paulussen (PhD) is a health scientist with specific expertise in health promotion and education. He graduated from Maastricht University and his PhD thesis was about implementation of health education innovations. He is affiliated with TNO Innovation for Life, and Expertise Group Life Style in Leiden, Netherlands.

Ethics approval and consent to participate

The respondents of all Regional Health Services voluntarily took part in the survey. Prior to their participation, respondents were informed that their contributions would be made anonymous and would not be reducible to individuals or individual RHS organizations. On the basis of these conditions and prior to the execution of the survey, respondents agreed to take part and gave informed consent to use the survey results in publications. Approval by the ‘Dutch Medical Research Involving Human Subjects Act’ was therefore not applicable.

Consent for publication

Not applicable.

Competing interests

The Guideline for Local Health Policy is designed by collaborating national health institutes and the National Institute for Public Health and the Environment. All authors declare that they have no (financial or non-financial) competing interests in relation to this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Research framework of determinants of guideline use
See this image and copyright information in PMC

References

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