Most Important Contextual Factors for the Implementation of Self-Management Interventions

The variation in successful implementation of self-management interventions (SMIs) can be partly explained by the differences in the context in which a SMI is implemented. Understanding why, when and where SMIs work most effectively is crucial for implementation. This study aimed to identify important Contextual Factors (CFs) for the successful implementation of SMIs for type 2 diabetes, obesity, COPD and heart failure. This study was conducted as part of the COMPAR-EU study. A literature study identified 31 CFs related to the patient (n=14), health care professionals (HCP) (n=10), their interaction (n=3) or the setting/organization (n=4) of the SMIs. A Delphi study with 44 experts was set up to identify for SMIs in general, and nine component of SMIs, which CFs contribute most to their successful implementation. The Delphi consisted of two survey rounds and an online consensus meeting in which the 31 CFS were scored, prioritized and discussed. This resulted in Top5’s of most important CFs per component and disease-specific comments. The most important CFs identified for several component of SMI overlapped to a great extent. Overall, the most important CF identified by stakeholders was: HCPs’ ability to adapt the advice, communication or intervention to patients’ situation and level of knowledge. This implies that ‘tailoring’ is an important asset for HCPs. Most CFs originated from the literature and were common across diseases although also disease-specific CFs were found. CFs are important to take into account when implementing successful SMI in real life settings. The Findings: of this study will be incorporated into a self-management platform which provides support for policymakers, guideline developers, HCPs and patients to make informed decisions on the adoption of the most suitable SMIs in a given context and and on which CFs to take into account for successful implementation.