title: Finding common ground in implementation: towards a theory of gradual commonality.
abstract: This article reports on an empirical study that aimed to design a practice-based theory about collaboration on the local implementation of a nationally developed health-promoting intervention. The study's objective is to better understand the dynamic process of complex collaboration. The research is based on a Delphi study among some 100 individuals in local and regional networks, in which various professionals work together to implement the BeweegKuur, which translates as 'course of exercise'. The BeweegKuur is a combined lifestyle intervention aimed at promoting sufficient physical exercise and a healthy diet among people in the Netherlands who are overweight and at risk of diabetes. The Delphi study in three rounds systematically and interactively constructs a common perspective on implementation, reflecting stakeholders' ideas about the collaboration and providing an insight into how these ideas are influenced by the context of the implementation. The statistical and qualitative analyses of the responses to the feedback in the Delphi study form the basis for this practice-based theory on complex collaboration, called the theory of gradual commonality. During interaction, consensus gradually emerges about co-creation as a collaboration strategy. Co-creation leaves room for various ways of achieving the ambitions of the BeweegKuur. This article discusses the importance of this practice-based theory and the value of the Delphi research strategy for promoting health.
authors.affiliation: Netherlands Institute for Sport & Physical Activity, Ede, the Netherlands marian.terhaar@nisb.nl.
authors.forename: Marian
authors.initials: M
authors.lastname: Ter Haar
authors.affiliation: ASCoR (Amsterdam School for Communication Research), University of Amsterdam, Amsterdam, the Netherlands; Strategic Communication Group, Wageningen University, Wageningen, the Netherlands.
authors.forename: Noelle
authors.initials: N
authors.lastname: Aarts
authors.affiliation: ASCoR (Amsterdam School for Communication Research), University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Piet
authors.initials: P
authors.lastname: Verhoeven
mesh_terms: D003299:Cooperative Behavior; D003697:Delphi Technique; D004032:Diet; D015444:Exercise; D066296:Grounded Theory; D006293:Health Promotion; D006801:Humans; D009426:Netherlands; D050177:Overweight / Q000517:prevention & control; D011320:Primary Health Care / Q000379:methods; D011634:Public Health
keywords: co-creation; collaboration; grounded theory; implementation science