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BACKGROUND: Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies. METHODS: A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically. RESULTS: From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers. CONCLUSIONS: This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual' skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its success. TRIAL REGISTRATION: PROSPERO - CRD42020153821 .

Background Implementation research has delved into barriers to implementing change and interventions for the implementation of innovation in practice. There remains a gap, however, that fails to connect implementation barriers to the most effective implementation strategies and provide a more tailored approach during implementation. This study aimed to explore barriers for the implementation of professional services in community pharmacies and to predict the effectiveness of facilitation strategies to overcome implementation barriers using machine learning techniques. Methods Six change facilitators facilitated a 2-year change programme aimed at implementing professional services across community pharmacies in Australia. A mixed methods approach was used where barriers were identified by change facilitators during the implementation study. Change facilitators trialled and recorded tailored facilitation strategies delivered to overcome identified barriers. Barriers were coded according to implementation factors derived from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Tailored facilitation strategies were coded into 16 facilitation categories. To predict the effectiveness of these strategies, data mining with random forest was used to provide the highest level of accuracy. A predictive resolution percentage was established for each implementation strategy in relation to the barriers that were resolved by that particular strategy. Results During the 2-year programme, 1131 barriers and facilitation strategies were recorded by change facilitators. The most frequently identified barriers were a ‘lack of ability to plan for change’, ‘lack of internal supporters for the change’, ‘lack of knowledge and experience’, ‘lack of monitoring and feedback’, ‘lack of individual alignment with the change’, ‘undefined change objectives’, ‘lack of objective feedback’ and ‘lack of time’. The random forest algorithm used was able to provide 96.9% prediction accuracy. The strategy category with the highest predicted resolution rate across the most number of implementation barriers was ‘to empower stakeholders to develop objectives and solve problems’. Conclusions Results from this study have provided a better understanding of implementation barriers in community pharmacy and how data-driven approaches can be used to predict the effectiveness of facilitation strategies to overcome implementation barriers. Tailored facilitation strategies such as these can increase the rate of real-time implementation of innovations in healthcare, leading to an industry that can confidently and efficiently adapt to continuous change.

Between two possible practices when supervising a remote synchronous evaluation, during the COVID-19 pandemic, the majority of Spanish universities opted for the use of videoconferences with audio and active video, instead of implementing e-proctoring. Thus, in order to analyze the reasons for this non-implementation and take measures so that its use can be extended in the Spanish university system, this study focused on identifying the critical factors in the decision of Spanish universities to accept and implement e-proctoring as a method of remote supervision. For this, a causal study was carried out using the methodology of fuzzy cognitive maps, and the data obtained were processed through the FCMappers tool. This allowed a glimpse of the key role played by students in this non-implementation (who alleged the non-possibility of having the resources necessary for the use of e-proctoring and the violation of privacy that the use of this tool entailed) and highlighted the role of the “pressure or incentives from government” factor if these allegations are to be eliminated and if e-proctoring is to be implemented in Spanish universities

Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists Abstract Introduction: The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). Methods: Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains Framework (TDF), followed by an inductive analysis to identify sub-themes within each domain. Results: SLPs frequently encountered barriers within three TDF domains: Environmental Context and Resources (e.g., difficulties integrating the FOCUS into assessment sessions and intervention schedules), Beliefs about Consequences (e.g., beliefs that data collected using the FOCUS lack relevance to clinical practice), and Social Influences (e.g., administration of the FOCUS harmed rapport with families). Commonly reported facilitators were found in the Behavioural Regulation (e.g., reminder system) and Environmental Context and Resources (e.g., availability of administrative personnel and technology support) domains. Conclusions: SLPs identified barriers and facilitators to implementing an evidence-based outcome measure into practice. Insights drawn from SLPs’ perspectives will support the design of new methods to improve the implementation of functional outcome measurement tools within programs.

Background Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies. Methods A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically. Results From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers. Conclusions This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual’ skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its success. Trial registration PROSPERO - CRD42020153821.

Background Research in global mental health (GMH) has previously documented how contextual factors like political instability, poverty and poorly-funded health infrastructure continue to compromise effective and equitable mental health service delivery. There is a need to develop more feasible and evidence-based solutions through implementation research. This paper, one in a series pertaining to implementation in GMH projects worldwide, focuses on implementation factors influencing mental health service delivery. Methods This is a qualitative study carried out as part of a Theory of Change-driven evaluation of Grand Challenges Canada’s (GCC’s) Global Mental Health portfolio. Purposive sampling was used to recruit twenty-nine GCC grantees for interviews. A semi-structured interview schedule was used to guide the interviews which were recorded and subsequently transcribed. Transcripts were double-coded and analyzed in NVivo 11 using framework analysis. This paper reports results related to detection and treatment of mental illness, mental health promotion and prevention of mental illness. Results Key barriers included: lack of appropriate human resources and expertise for service delivery; lack of culturally appropriate screening tools and interventions; and difficulties integrating services with the existing mental health system. Formative research was a key driver facilitating the cultural adaptation of mental health detection, treatment, promotion and preventative approaches. Recruiting local providers and utilizing mHealth for improving screening, monitoring and data management were also found to be successful approaches in reducing workforce burden, improving sustainability, mental health literacy, participant engagement and uptake. Conclusions The study identifies a number of key barriers to and drivers of successful service delivery from the perspective of grantees implementing GMH projects. Findings highlight several opportunities to mitigate common challenges, providing recommendations for strengthening systems- and project-level approaches for delivering mental health services. Further, more inclusive research is required to inform guidance around service delivery for successful implementation, better utilization of funding and improving mental health outcomes among vulnerable populations in low-resource settings.

Research background:Towards the end of the previous century the issue of management of diversity in organisations gained a prominent place in both academic and societal debates. For any multicultural country, such as the United States or Great Britain, the issue of diversity is not new. However, diversity has not been as frequently researched in the countries of the Visegrad region: the Slovak Republic, the Czech Republic, Poland and Hungary.Purpose of the article:Using the data about 278 business organizations in Slovakia, we focus on the background of the implementation of diversity management from the point of view of factors having a direct influence on this process. We evaluate the influence of the legal form (as an expression of the number of owners and the ability to quickly adopt a new concept) of the business organisation, the size (number of employees) of the business organisation, the share of the foreign capital in the ownership structure of the organisations, the sector of economy the organization operates in, its performance and the existence of HR unit in the organizational structure.Methods:To evaluate the influence of the selected factors linear modelling was used.Findings & Value added:The study theoretically contributes to human resource management, talent management and organizational behaviour theories, and offers several policy implications for decision makers. Specifically, it deals with the relationship between the implementation of the diversity management selected organizations` characteristics.

The Mandatory use of ict in saudi secondary schools within the framework of the ict-related educational reform is a response to the requirements of the digital age. however, there is a discrepancy between what teachers want to do to promote ict integration and what they can really do since they are limited by poor equipment. Saudi Arabia Has Difficulties moving on from the transition stage of ICT adoption and adaptation to wide-scale ict integration. although all saudi teachers are ict adopters, they are reluctant to adapt western uses of ict tools without understanding their cultural appropriateness with regard to the specific saudi context that is deeply grounded in a multi-century islamic tradition of teaching. this article explores technical, political, and cultural appropriateness of ict tools in saudi secondary schools with a view to promoting ict integration from the mandatory adoption stage to ict integration.

O programa Seis Sigma tem recebido atencao das organizacoes devido aos relatos dos ganhos financeiros obtidos com sua implantacao. Porem, os fatores de implantacao que norteiam esse programa ainda nao sao consensuais entre pesquisadores ao redor do mundo. Diante desse contexto, essa pesquisa objetiva identificar os fatores associados a implantacao do Seis Sigma em empresas que operam no Brasil. A coleta de dados foi feita por meio de um questionario elaborado a partir da literatura sobre Seis Sigma, que foi aplicado a populacao-alvo de 483 clientes de empresas de consultoria em Seis Sigma, sendo que 45 dessas empresas responderam. Os dados foram analisados mediante a tecnica multivariada da analise fatorial exploratoria que objetivou contribuir para a busca de fatores latentes que pudessem descrever as variaveis individuais originais do questionario em um numero menor de conceitos. Como resultados, foram encontrados os seguintes fatores associados a implantacao do Seis Sigma: disponibilizacao de dados, infraestrutura previa e treinamento, metas e ganhos, implementacao da solucao, resistencia a mudanca, envolvimento da alta administracao e pensamento estatistico. Tais resultados fornecem ao gerenciamento do programa Seis Sigma uma visao mais compreensiva. DOI: http://dx.doi.org/10.21714/1679-18272017v15n2.p519-529

Life cycle cost management is an integral part of buildings construction. The life cycle cost approach can be considered an objective approach because it considers all life cycles of buildings. Information and communication technology is one of the critical factors for the success of construction projects. Several studies point to the importance of information and communication technology use in life cycle cost management. Generally, information and communication technology can be helpful in the cost management process of buildings. However, few implementation factors of information and communication technology are used in the life cycle cost management of buildings. The research assumes that the most critical implementation factor is the investment cost for information and communication technologies used in cost management during the life cycle. The relative importance index method was used to evaluate and quantify the final rank of implementation factors. The Kruskal–Wallis test was used to confirm or reject research results that were statistically significant.

Background Evidence-based guidelines recommend that all newly diagnosed colon cancers be screened for Lynch syndrome (LS). Best practices for implementing universal tumor screening have not been extensively studied. Purpose We interviewed a range of stakeholders in an integrated health care system to identify initial factors that might promote or hinder the successful implementation of a universal (LS) screening program. Methods We conducted interviews with health plan leaders, managers, and staff. Interviews were audio recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). Results We completed 14 interviews with leaders/managers and staff representing involved clinical and health plan departments. While in general stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote/hinder implementation. Facilitating factors included: 1) perceived benefits of screening for patients and organization; 2) collaboration between departments; and 3) availability of organizational resources. Barriers were also found, including: 1) lack of awareness of guidelines; 2) lack of guideline clarity; 3) staffing and program “ownership” concerns; and 4) cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. Conclusion We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication; patient and provider/staff education; and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

Dagens samhälle präglas av en ständig förändring och utveckling, vilket ställer krav på att skolan ska utvecklas i samma takt som det övriga samhället. Skolan ska vara likvärdig för alla. Hur kan detta försäkras om man inte vet vilka faktorer som påverkar en implementering av pedagogiska modeller? Genom att säkerställa de faktorer som påverkar implementeringen kan också ett bättre resultat uppnås. Därmed blir det troligare att den nya pedagogiska modellen används och blir en del av den dagliga verksamheten. För att möjliggöra en implementering genomförs ett förändringsarbete i organisationen. Vi har genomfört en kvalitativ studie vars syfte är att undersöka vilka faktorer lärare upplever kan påverka implementeringsresultatet av en ny pedagogisk modell i skolan. Undersökningen har genomförts på tre skolor i en kommun i Sverige. Intervjuformen har varit semistrukturerad varav två har hållits i grupp och en enskild. Genom intervjuerna har vi samlat empiri till vår studie. Resultatet visar att det finns många olika faktorer som påverkar, ofta i kombination med varandra, till hur väl en implementering blir. De faktorer som är betydande och har uppkommit i vår undersökning är följande: Relevans, inställning, fördelaktig, lättanvänd, anpassningsbar, coaching, stöttning, tid, delaktighet, system för uppföljning, tydliga resultat, kultur och kommunikation. Todays society is characterized by a constant change and development, which requires the school to develop at the same rate as the rest of society. The school should be equivalent to everyone. How can this be insured if we do not know which factors that affect the implementation of educational models? By ensuring the factors that affect implementation, better results can be achieved. This makes it more likely that the new educational model is used and becomes part of the everyday work. To make an implementation possible, a change work is carried out in the organization. We have conducted a qualitative study whose purpose is to study which factors teachers experience may affect the implementation of a new educational model in school. The survey has been conducted at three schools in a town in Sweden. The form of the interview has been semi-structured, two of which have been held in groups and one individual. Through the interviews we have acquired empirical evidence for our study. The result show that there are many different factors that affects, often in combination with each other, how well an implementation results in. The factors that are significant and have been made visible in our survey are the following: Relevance, attitude, advantageous, easy-to-use, customizable, coaching, support, time, participation, follow-up systems, clear results, culture and communication.

Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, “Improving Research of Employer Practices to Prevent Disability”, held October 14–16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.

This research studies the influence range of the organizational, planning and technical factors within the information quality, system quality and information systems services quality, in the user satisfaction, based on the designed model research for this purpose. The empirical study takes place in six Higher Education Institutes (94 questionnaires) by the Partial Least Square statistic tool. The results has shown that Organizational Factor (information needs, management support, institutional objectives satisfaction) is which has the most impact because its high correlation value (R=0.624; R=0.435 yR=0.428) and signifi cance (p Esta investigación estudia el nivel de influencia de los factores organizacional, planificación y técnico con la calidad de la Información, del sistema y de los servicios en la satisfacción del usuario, basado en un modelo diseñado para este propósito. El estudio empírico hecho en seis universidades mexicanas por medio de PLS, muestra que el Factor Organizacional es el que tiene un mayor impacto por sus altos valores de correlación (R=0.624; R=0.435 y R=0.428) y significancia en las tres hipótesis planteadas con una varianza explicada del 78.8% en la Satisfacción del Usuario, quienes piensan que la calidad de los sistemas les ayudan a aumentar la productividad en su toma de decisiones.

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

International audience; Objective We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care.Methods We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings.Results We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources.Discussion This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation.Conclusions This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

This doctoral research examines the issue of implementation quality in mental health promotion and prevention programs that are being delivered in the community settings in the Region of Istria, taking into account the programs’ characteristics and the support system surrounding them. The general aim of this doctoral research was to study implementation processes and their outcomes in prevention programs in Croatia. In order to answer above stated aim, this doctoral research was conducted through pre-research concerning the construction of implementation scales and two studies, 1) study on implementation quality and 2) study of the impact of Training for Prevention. Sample of the study of implementation quality included managers, implementers and participants from the cohort of 24 community-based mental health promotion and prevention programs in Istria. Data for each of 24 included programs were collected from 24 managers and 55 program implementers. Altogether 434 program participants gave their report about the implementation quality at mid-intervention while 744 participants gave their report at post-test implementation assessment. In general, results have shown that implementation factors are consistently rated lower than indicators of implementation quality. Managers report upon lower levels of implementation factors than implementers and those results could indicate possibilities for future investments. On the general level, average results per indicators of implementation quality support the conclusion that implementation quality in the studied mental health and prevention programs in the County of Istria are satisfactory to high in the perception of implementers and participants. The study on the impact of the Training for Prevention examined if the newly designed Training for Prevention has affected implementation factors and implementation quality in the experimental group. Analyses have shown that program managers and implementers don’t report about improved implementation. Post-test differences have shown that program participants report upon the higher level of two indicators of implementation quality, quality of delivery and responsiveness than participants in the control conditions. Regarding the intervention Training for Prevention effectiveness and its implications on the level of implementation quality, it could be concluded that Training seems promising but its impact still has to be further researched., Kroz dugogodišnju i plodnu suradnju Istarske županije s Edukacijsko-rehabilitacijskim fakultetom te međunarodnim istraživačkim centrima, čelnici unutar Upravnog odjela za zdravstvo i socijalnu skrb koji je zadužen za prevenciju problema u ponašanju i promociju mentalnog zdravlja, postupno razvijaju temelje za prevencijsku praksu utemeljenu na dokazima. Prema trenutnom stanju u području, upravo zahvaljujući naporima spomenutog Upravnog odjela, može se zaključiti da je Istarska županija otišla najdalje u ulaganjima u znanstveno utemeljenu prevenciju. Upravni odjel za zdravstvo i socijalnu skrb Istarske županije provodi procjenu potreba, ima svoje preventivne prioritete te jasno usmjerena ulaganja, povezan je s domaćim i internacionalnim istraživačkim centrima te primjerima dobre prakse, zainteresiran je za evaluaciju učinkovitosti programa te kontinuirano ulaže u kvalitetu prevencijske prakse. Zbog potrebe za donošenjem novog Plana za zdravlje građana Istarske županije, županijska uprava trebala je osigurati transparentnu dodjelu sredstava tj. financiranje onih programa koji poštuju kriterije kvalitete i učinkovitosti. Pokretu za razvoj jasno definiranih kriterija kvalitete pridonijele su i nove znanstvene spoznaje o prediktorima učinkovitosti kao i veća senzibiliziranost provoditelja programa i voditelja organizacija na povratne informacije koje su dobivali kod ocjena projektnih prijava. Sukladno navedenome, dugogodišnja suradnja Upravnog odjela za zdravstvo i socijalnu skrb Istarske županije s Edukacijsko-rehabilitacijskim fakultetom, Sveučilišta u Zagrebu u okviru projekta Zajednice koje brinu nastavljena je i kroz istraživački podprojekt pod nazivom »Preffi - osiguranje kvalitete u Istarskoj županiji«. Ulaganje u kvalitetu i učinkovitost tj. u implementacijske i programske ishode bilo je planirano kroz primjenu Preffi 2.0 instrumenta u hrvatskim uvjetima te provedbu novo osmišljene intervencije Trening za prevenciju. Preffi 2.0 je mjera za upravljanje učincima promocije zdravlja koja je osmišljena u Nizozemskoj a koristi se za procjenu učinkovitosti i razvoj kvalitete preventivnih programa (Molleman, 2005; Molleman i suradnici, 2005). Instrument se temelji na poduzimanju teorijski utemeljenih koraka te izbora koji trebaju biti slijeđeni tijekom dizajna i primjene programa kako bi se povećala krajnja učinkovitost preventivnih intervencija. S obzirom da su voditelji organizacija i provoditelji programa različitog profesionalnog porijekla, s obzirom na to da je prevencijska znanost nova disciplina koja raspolaže jasnim znanstveno utemeljenim preporukama a da se upravo trening i stručno osposobljavanje provoditelja intervencija najčešće napominje kao način na koji se može utjecati na kvalitetu programa, Trening za prevenciju osmišljen je kao konkretna metoda ulaganja u kvalitetu. Dugoročni cilj projekta bio je smanjiti mentalne i ponašajne probleme djece i mladih na području Istre kroz osnaživanje prevencijske prakse koja je utemeljena na dokazima. Da bi se postigao ovaj krajnji ishod, kratkoročniji ciljevi projekta bili su: 1. Kroz provedbu intervencije "Trening za prevenciju" poboljšati znanja o načelima znanstveno utemeljene prevencijske prakse kod onih voditelja organizacija, autora i provoditelja preventivnih aktivnosti koji su financirani od strane Istarske županije; 2. Poboljšati kvalitetu prijavnih prijedloga organizacija koje se javljaju za sufinanciranje pri Odjelu za zdravstvo i socijalnu skrb Istarske županije; 3. Poboljšati implementacijske i programske ishode onih promotivnih i preventivnih programa koji su financirani od strane Odjela za zdravstvo i socijalnu skrb Istarske županije; 4. Utemeljiti jasne znanstvene kriterije kvalitete koji će služiti za financiranje preventivnih programa u Istarskoj županiji. Glavna pretpostavka projekta bila je da je ugradnja principa znanstvene utemeljenosti, tzv. prediktora učinkovitosti, ključna za poboljšanje kvalitete i učinkovitosti programa koji se bave djecom, mladima i obiteljima u Istarskoj županiji. Ovo doktorsko istraživanje bavi se empirijskom studijom kvalitete implementacije preventivnih programa koji se provode na području Istarske županije, uzimajući u obzir karakteristike sustava te obilježja podrške koja ih okružuje. Opći cilj ovog doktorskog rada bio je proučiti procese implementacije i njihove ishode u preventivnim programima na uzorku programa koji se bave prevencijom problema u ponašanju i promocije mentalnog zdravlja u Istarskoj županiji. Kako bi odgovorilo na navedeni cilj, ovo doktorsko istraživanje je provedeno u tri koraka: 1) predistraživanje za konstrukciju instrumenata za mjerenje implementacije; 2) studija kvalitete implementacije te 3) studija utjecaja Treninga za prevenciju na kvalitetu implementacije. U svrhu ovog doktorskog istraživanja, na temelju pregleda literature i dosadašnjih teorija implementacije, osmišljen je konceptualni model implementacije koji u odnos stavlja implementacijske faktore te indikatore kvalitete implementacije. Sukladno konceptualnom modelu, konstruirane su i nove mjere koje obuhvaćaju sve aspekte implementacije u modelu. Ovaj model objedinjuje ekološke, individualne i intervencijske faktore potrebne da bi proces implementacije bio uspješan, a opisani su u radu Fixsen i suradnika (2005, 2009), Domitrovich i suradnika (2008), u radu autora Durlaka i Duprea (2010) te Durlaka (2010). Ovaj konceptualni model implementacije uključuje implementacijske faktore sa dviju razina. Prva razina odnosi se na kapacitet same organizacije da osigura podršku implementaciji programa: osiguravanje adekvatnog treninga i osposobljavanja provoditelja; podrška pojedincima koji provode program; stavovi prema intervenciji te praćenje procesa implementacije programa. Druga razina odnosi se na sam program te obuhvaća čimbenike poput vještina provoditelja programa; stavova provoditelja prema intervenciji te standardizacije programa. Upravo su ovi implementacijski faktori odabrani od cijelog niza faktora prezentiranih u literaturi kao oni koji su najzastupljeniji u svim pregledima jer su povezani s programskim ishodima. Isto tako, prema iskustvu istraživača, ovi su se faktori činili najrelevantnijima za hrvatski kontekst. Kvaliteta implementacije, primarni ishod prezentiranog konceptualnog modela, zastupljena je kroz pet indikatora kvalitete implementacije o kojima su informacije prikupljane i od provoditelja programa i od samih sudionika intervencije. Četiri od pet tih dimenzija su definirali Durlak i Dupre (2008): vjernost (fidelity), kvaliteta provedbe programa (quality of delivery), doziranje (dosage) te reakcije sudionika programa (participants' responsiveness). Mjere koje se odnose na reakcije sudionika programa uključivale su reakcije sudionika na samu intervenciju, reakcije sudionika na provoditelja programa te čestinu pohađanja programa. Uz te četiri već poznate dimenzije implementacije, odlučeno je da će se od provoditelja i sudionika intervencija prikupiti i indirektna mjera kvalitete implementacije, informacije o percepciji učinka samog programa na njihov život (perceived program impact). Ova se dimenzija temelji na pretpostavci da ukoliko provoditelji ili sudionici programa izvještavaju o utjecaju intervencije na njihovo ponašanje, vrlo je vjerojatno da je implementacija programa bila uspješna. Osnovna pretpostavka modela odnosi se na povezanost i međuzavisnost implementacijskih faktora i indikatora kvalitete implementacije što je i bio predmet studija u ovom doktorskom radu. Uzorak ove doktorske disertacije bio je slojevit: činila ga je kohorta od 24 programa prevencije problema u ponašanju i promocije mentalnog zdravlja tj. ukupan uzorak činili su voditelji uključenih organizacija, provoditelji programa i sami sudionici intervencija koje su se provodile. Ovi su programi odabrani iz skupine programa koje financira Upravni odjel za zdravstvo i socijalnu skrb Istarske županije. Uključeni programi podijeljeni su na kontrolnu i eksperimentalnu skupinu programa metodom putem rezultata na Preffi 2.0 instrumentu te metodom izjednačavanja parova prema karakteristikama programa, broju i tipu sudionika te dužini provedbe. U prikupljanju podataka sudjelovalo je 24 voditelja organizacija te 55 provoditelja programa, iako se broj sudionika mijenjao ovisno o točci mjerenja. Implementacijski faktori i indikatori kvalitete implementacije mjereni su sa četiri novokonstruirana upitnika. Trening za prevenciju u trajanju od 32 sata uz 3 sata individualnih konzultacija proveden je sa voditeljima i provoditeljima 12 programa koji su bili u eksperimentalnoj skupini. U Treningu su bile obuhvaćene sve teme relevantne za učinkovitu implementaciju i postizanje ishoda programa: analiza problema, procjena potreba, važnost teorijske utemeljenosti, izrada logičkog modela, postavljanje ciljeva i rezultata, značaj interaktivnih metoda rada sa korisnicima, važnost standardizacije programa, evaluacija učinaka te metode zagovaranja i osiguravanja podrške. Kako bi se prikupile informacije i o kvaliteti procesa implementacije te o utjecaju i učinku intervencije Trening za prevenciju, organizirana su mjerenja u dvije vremenske točke. S obzirom na to da program već mora biti u primjeni kako bismo mjerili implementaciju, odlučeno je da prva točka mjerenja bude nakon prve trećine/prve polovice implementacije programa dok je druga točka mjerenja bila nakon same provedbe programa. S obzirom na heterogenost programa u proučavanoj kohorti, posebice razlike u trajanju programa, za neke programe nije bilo moguće organizirati dva mjerenja već samo jedno mjerenje na samom kraju provedbe intervencije. Upravo je stoga nakon prve trećine implementacije u istraživanju sudjelovalo 434 sudionika dok je uzorak sudionika intervencija na kraju provedbe činilo 744 ispitanika. S obzirom na vrstu programa, sudionici intervencija pa i istraživanja bili su i odrasli i djeca. Od 434 sudionika u prvom mjerenju, 297 ih je bilo djece i tinejdžera dok je u drugom mjerenju od 744 sudionika istraživanja 513 djece i tinejdžera. Kako bi se odgovorilo na sve istraživačke probleme, provedena je analiza pouzdanosti i faktorska analiza za odgovor na prvi istraživački problem, deskriptivna analiza za drugi istraživački problem, korelacijska analiza te multipla regresija provedena je za treći i četvrti istraživački problem dok je na peti problem odgovoreno uz pomoć hijerarhijskog linearnog modeliranja. Preliminarno istraživanje metrijskih karakteristika instrumenata je pokazalo da su četiri novokonstruirane mjere visoke unutarnje konzistencije te da pokazuju dobru konstruktnu valjanost. Rezultati studije kvalitete implementacije su pokazali da su u promatranoj kohorti programa iz Istarske županije implementacijski faktori kontinuirano procijenjivani niže od indikatora kvalitete implementacije. Voditelji organizacija su bili posebno kritični prema implementacijskim faktorima, te su se posebno kritično osvrnuli na ulaganja u trening i znanja provoditelja programa, standardizaciju samih programa te ulaganja u sustav praćenja. Provoditelji programa implementacijske faktore vide slično kao i voditelji, ali su nešto blaži u ocjenama. Generalno govoreći, prosječni rezultati za indikatore kvalitete implementacije koji su dobiveni iskazom provoditelja i sudionika programa ukazuju na zaključak da je kvaliteta implementacije programa koji su u fokusu ove disertacije zadovoljavajuća. Studija učinka Treninga za prevenciju na kvalitetu implementacije ispitivala je da li intervencija ima utjecaja na razinu implementacijskih faktora i indikatore kvalitete implementacije. Hijerarhijsko linearno modeliranje pokazalo je da voditelji organizacija i provoditelji programa ne izvještavaju o poboljšanju implementacijskih faktora tj. i kod voditelja organizacija i kod provoditelja programa vidljiv je trend viših rezultata kod kontrolne skupine već u prvoj točci mjerenja. S obzirom da je Trening za prevenciju kojem je bila izložena eksperimentalna skupina sadržavao teme koje su se odnosile upravo na implementacijske faktore, jedna od mogućnosti je da je eksperimentalna skupina upravo zbog Treninga bila senzibiliziranija i kritičnija prema organizacijskim i kontekstualnim faktorima unutar svojih programa. Što se tiče indikatora kvalitete implementacije za koje su samoiskaz davali i provoditelji i ispitanici, analize nisu pokazale utjecaj Treninga na indikatore kvalitete implementacije viđene iz perspektive provoditelja programa. Kada je riječ o samim sudionicima programa, na post-testu su sudionici programa iz eksperimentalne skupine izvještavali pozitivnije o sva četiri ispitivana indikatora kvalitete implementacije. Statistički značajne razlike su pronađene kod dva od četiri indikatora kvalitete implementacije: sudionici iz eksperimentalne skupine izvještavaju o višoj kvaliteti provedbe programa (quality of delivery) i većim reakcijama na intervenciju te provoditelja (participants' responsiveness). Isto tako, uz pomoć hijerarhijskog linearnog modeliranja provedene su analize moderatora kako bi se provjerilo da li su neki moderatori utjecali na učinak Treninga za prevenciju. Testiran je utjecaj aktivnosti voditelja, dužine programa, tipa ispitanika (djeca, tinejdžeri, odrasli) te tipa programa (roditeljski program, program promocije mentalnog zdravlja te program prevencije ovisnosti). Rezultati su pokazali da su aktivnost voditelja organizacije i dužina programa značajni moderatori učinka Treninga za prevenciju na iskaze od strane ispitanika. Čini se da Trening za prevenciju ima veći učinak na kraće programe: gledano iz perspektive sudionika intervencija, kraći programi iz eksperimentalne skupine čiji su voditelji i provoditelji sudjelovali u Treningu za prevenciju pokazali su veću kvalitetu implementacije u usporedbi s kontrolnom skupinom programa. Analize moderatora su također pokazale da Trening za prevenciju ima veću učinak na one programe kod kojih je voditelj uključen samo formalno, bez neke istinske podrške provedbi. Kada se takvi programi koji nemaju pravu podršku voditelja organizacije usporede međusobno, programi iz eksperimentalne skupine imali su veću kvalitetu provedbe i bolje reakcije od strane sudionika u usporedbi s kontrolnom skupinom programa. Ova doktorska disertacija prvi je i jedinstven primjer istraživanja kvalitete implementacije preventivnih programa u Hrvatskoj. S obzirom da je riječ o novom području i u svjetskim okvirima, pregled svih istraživanja također je značajan za područje promocije mentalnog zdravlja i prevencije problema u ponašanju. Znanstveni doprinos predstavlja i konstrukcija četiri instrumenta za mjerenje implementacije te osmišljavanje intervencije koja ima potencijal utjecati na kvalitetu rada praktičara tj. na prevencijsku praksu. Učinkovitost Treninga za prevenciju još treba biti dodatno istražena u novim istraživanjima. Zadnje poglavlje ove disertacije nudi analizu svih manjkavosti i ograda studije te donosi neke preporuke za praksu i buduća istraživanja.

Background Interoperable electronic health record (EHR) solutions are currently being implemented in Canada, as in many other countries. Understanding EHR users’ perspectives is key to the success of EHR implementation projects. This Delphi study aimed to assess in the Canadian context the applicability, the importance, and the priority of pre-identified factors from a previous mixed-methods systematic review of international literature. Methods A three-round Delphi study was held with representatives of 4 Canadian EHR user groups defined as partners of the implementation process who use or are expected to use EHR in their everyday activity. These groups are: non-physician healthcare professionals, health information professionals, managers, and physicians. Four bilingual online questionnaire versions were developed from factors identified by the systematic review. Participants were asked to rate the applicability and the importance of each factor. The main outcome measures were consensus and priority. Consensus was defined a priori as strong (≥ 75%) or moderate (≥ 60-74%) according to user groups’ level of agreement on applicability and importance, partial (≥ 60%) when participants agreed only on applicability or importance, or as no consensus (< 60%). Priority for decision-making was defined as factors with strong consensus with scores of 4 or 5 on a five-point Likert scale for applicability and importance. Results Three Delphi rounds were completed by 64 participants. Levels of consensus of 100%, 64%, 64%, and 44% were attained on factors submitted to non-physician healthcare professionals, health information professionals, managers, and physicians, respectively. While agreement between and within user groups varied, key factors were prioritized if they were classified as strong (≥ 75% from questionnaire answers of user groups), for decision-making concerning EHR implementation. The10 factors that were prioritized are perceived usefulness, productivity, motivation, participation of end-users in the implementation strategy, patient and health professional interaction, lack of time and workload, resources availability, management, outcome expectancy, and interoperability. Conclusions Amongst all factors influencing EHR implementation identified in a previous systematic review, ten were prioritized through this Delphi study. The varying levels of agreement between and within user groups could mean that users’ perspectives of each factor are complex and that each user group has unique professional priorities and roles in the EHR implementation process. As more EHR implementations in Canada are completed it will be possible to corroborate this preliminary result with a larger population of EHR users.

Part 6: Research in Progress and Practice; International audience; This research aims to explore factors responsible for successful implementation of ERP systems in Indian organizations. The paper also aims to explore the similarities and differences in ERP system adoption between locally-owned and multinational companies in India. The data was collected from 56 project managers and business analysts with ERP expertise from both locally-owned Indian and multinational companies. The findings suggest that Business Plan and Vision, Project Management and Top Management Support were perceived as the three most important factors responsible for successful implementation. The result revealed no significant differences between Indian and multinational companies, hence indicating that both types of firms undertake the ERP implementations in the same manner.

El crecimiento del Internet, el aumento en los mercados globales y la transformación de economías y sociedades industriales a economías de servicio basadas en el conocimiento y en la información han cambiado el rol de los sistemas de información (SI) en los negocios. Los SI son el cimiento de productos basados en nuevos conocimientos y servicios en economías de conocimiento Las organizaciones corporativas han implementado proyectos de “Data Warehouse” (DW) para mejorar la capacidad de medir, de entender y de analizar las operaciones de negocio (Tdwi, 2002). Un DW extrae datos desde múltiples sistemas transaccionales u operacionales, los integra y almacena, convirtiéndolos en un nuevo producto (información). Este estudio ayuda a identificar los factores más importantes y a entender mejor la implementación de un DW para el caso de una empresa en Venezuela. The growth of the Internet, the increase in global markets and changing economies and industrial societies to service economies based on knowledge and information have changed the role of information systems (IS) in business. SIs are the foundation of new knowledge based products and services in knowledge economies, corporate organizations have implemented projects of “Data Warehouse” (DW) to improve the ability to measure, understand and analyze business operations (TDWI, 2002). A DW extracts data from multiple transactional or operational systems, integrates and stores, making a new product (information). This study helps to identify the most important and better understand the implementation of a DW in the case of a company in Venezuela. 43-53 mcabeza@usb.ve masbel@cantv.net