Veenstra, J.T. (2014) In hoeverre heeft de mate van implementatie invloed op de effectiviteit van een leefstijl interventie? thesis, Medicine.
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Abstract
Background About 50% of severe mentally ill (SMI) patients are overweight. They also have an increased risk of cardiovascular mortality. Unhealthy lifestyle behaviours in SMI patients contribute tot this increased risk. To improve cardio metabolic health in these patients, a lifestyle intervention, ELIPS (effectiveness of lifestyle interventions in psychiatry trail), has been designed. The aim of ELIPS was to study the effects of a lifestyle intervention that focuses on changing the obesogenic environment. ELIPS is a pragmatic trail, which means that the different locations can implement the intervention in a way that fits the local situation. The aim of the current study is to investigate whether the degree of implementation influences the ELIPS outcome. Methods During the ELIPS intervention several staff members, patients and team managers were interviewed and have answered questionnaires, an observation checklist was used to examine changes in the (obesogenic) environment. We used these data to investigate how many and what kind of lifestyle changes the locations had made. A score was developed for these changes, based on the strength of the effect and how many patients would be reached by the change. This score was used as the implementation score. A correlation was calculated between the implementation score and the ELIPS primary outcome measures (waist circumference and body mass index (BMI)). We furthermore aimed tot explain the degree of implementation with the Theoretical domains framework (TDF). Findings Hardly any significant relations were found between the degree of implementation and the ELIPS outcome. The TDF was not able to explain the degree of implementation. Discussion The questionnaires, which the patients answered, aren’t completely reliable. This population is known to have trouble answering questions. This is, among other things, due to cognitive problems and lack of concentration. The data collected from the staff members isn’t completely reliable as well. It’s possible the staff members have given social desired answers. Nevertheless the study remains useful, because changing lifestyle will always be influenced by motivation and care of the staff members. In other studies the degree of implementation proved to be important in the outcome, but we weren’t able to prove that the degree of implementation has played a part in the ELIPS study. The difference between other studies and the current study is, that the current study is a pragmatic trail. The other studies that investigated implementation were all regulated en more controlled. Due to the results of the current study we can conclude that the degree of implementation, in a pragmatic intervention-study, is of no importance to the study outcome.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Jörg, Dr. F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/262 |
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