title: How can the results of a qualitative process evaluation be applied in management, improvement and modification of a preventive community trial? The IHHP Study.
abstract: BACKGROUND
  This study reports the results of the qualitative process evaluation (PE) of the Isfahan Healthy Heart Program (IHHP), an integrated community-based trial for prevention and control of non-communicable diseases in Iran.
  
  
  METHODS
  The study explored the overall quality of program implementation. The participants, including designers of IHHP, stakeholders and community members (n = 60) were purposefully recruited from the intervention areas. Data collected from semi-structured interviews and field notes were analyzed using a modified thematic analysis.
  
  
  RESULTS
  Four main themes were identified. Our findings highlighted the key role of the resources as both facilitating and hindering factors. IHHP directors faced incompatibilities arising from negative perceptions/attitudes which resulted in decreased adherence to the program. Hence various strategies were used to motivate, strengthen and organize the human workforce implementing the program.
  
  
  CONCLUSIONS
  Recommendations arising from evaluation of the program were used in subsequent stages of implementation. Qualitative research is an important component of community trials which can improve their implementation.
authors.affiliation: Isfahan Cardiac Rehabilitation Research Center, Isfahan Cardiovascualr Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. ktrabiei@gmail.com.
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rabiei
authors.forename: Mousa
authors.initials: M
authors.lastname: Alavi
authors.forename: Heidarali
authors.initials: H
authors.lastname: Abedi
authors.forename: Sonia
authors.initials: S
authors.lastname: Zarfeshani