title: Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process.
abstract: One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process.
  
  
  
  A multidisciplinary community of practice group (n = 16) consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012-December 2013) to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data.
  
  
  
  Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group). Fidelity was rated as fairly high.
  
  
  
  The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future guideline development; it provides valuable information on how practitioners can be included in the development process, with the aim of increasing the implementability of the developed guidelines.
authors.affiliation: Unit of Intervention and Implementation Research for worker health, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden. Lydia.kwak@ki.se.
authors.forename: Lydia
authors.initials: L
authors.lastname: Kwak
authors.affiliation: Unit of Intervention and Implementation Research for worker health, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.|Occupational and Environmental Medicine Center, University Hospital, Region Östergötland, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Wåhlin
authors.affiliation: Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden.|Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden.
authors.forename: Kjerstin
authors.initials: K
authors.lastname: Stigmar
authors.affiliation: Unit of Intervention and Implementation Research for worker health, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
authors.forename: Irene
authors.initials: I
authors.lastname: Jensen
mesh_terms: D019983:Guideline Adherence; D006282:Health Personnel; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016272:Occupational Health / Q000706:statistics & numerical data*; D009786:Occupational Health Services / Q000458:organization & administration*; D009787:Occupational Medicine / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012108:Research Personnel; D013548:Sweden; D017132:Workplace
keywords: Evaluation; Practice guidelines; Process measures