TY - JOUR
T1 - Barriers and enablers in the implementation of a provider-based intervention to stimulate culturally appropriate hypertension education
AU - Beune, E.J.A.J.
AU - Haafkens, J.A.
AU - Bindels, P.J.E.
PY - 2011
Y1 - 2011
N2 - Objective: To identify barriers and enablers influencing the implementation of an intervention to stimulate culturally appropriate hypertension education (CANE) among health care providers in primary care. Methods: The intervention was piloted in three Dutch health centers. It consists of a toolkit for CAHE, training, and feedback meetings for hypertension educators. Data were collected from 16 hypertension educators (nurse practitioners and general practice assistants) during feedback meetings and analyzed using qualitative content analysis. Results: Perceived barriers to the implementation of the intervention fell into three main categories: political context (health care system financing); organizational factors (ongoing organizational changes, work environment, time constraints and staffing) and care provider-related factors (routines, attitudes, computer and educational skills, and cultural background). Few barriers were specifically related to the delivery of CANE (e.g. resistance to registering ethnicity). Enabling strategies addressing these barriers consisted of reorganizing practice procedures, team coordination, and providing reminders and additional instructions to hypertension educators. Conclusion and practice implications: The adoption of a tool for CAHE by care providers can be accomplished if barriers are identified and addressed. The majority of these barriers are commonly associated with the implementation of health care innovations in general and do not indicate resistance to providing culturally appropriate care.
AB - Objective: To identify barriers and enablers influencing the implementation of an intervention to stimulate culturally appropriate hypertension education (CANE) among health care providers in primary care. Methods: The intervention was piloted in three Dutch health centers. It consists of a toolkit for CAHE, training, and feedback meetings for hypertension educators. Data were collected from 16 hypertension educators (nurse practitioners and general practice assistants) during feedback meetings and analyzed using qualitative content analysis. Results: Perceived barriers to the implementation of the intervention fell into three main categories: political context (health care system financing); organizational factors (ongoing organizational changes, work environment, time constraints and staffing) and care provider-related factors (routines, attitudes, computer and educational skills, and cultural background). Few barriers were specifically related to the delivery of CANE (e.g. resistance to registering ethnicity). Enabling strategies addressing these barriers consisted of reorganizing practice procedures, team coordination, and providing reminders and additional instructions to hypertension educators. Conclusion and practice implications: The adoption of a tool for CAHE by care providers can be accomplished if barriers are identified and addressed. The majority of these barriers are commonly associated with the implementation of health care innovations in general and do not indicate resistance to providing culturally appropriate care.
U2 - https://doi.org/10.1016/j.pec.2010.02.015
DO - https://doi.org/10.1016/j.pec.2010.02.015
M3 - Article
C2 - 20303232
SN - 0738-3991
VL - 82
SP - 74
EP - 80
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
ER -