title: Sustaining program effectiveness after implementation: The case of the self-management of well-being group intervention for older adults.
abstract: The Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity.
  
  
  
  In the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants' baseline characteristics. Professionals completed questions regarding program fidelity.
  
  
  
  No significant differences were found on effect outcomes and adherence between IMP and RCT (all p≥0.135). Intervention effect sizes were equal (0.47-0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations.
  
  
  
  The effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity.
  
  
  
  The SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: m.m.goedendorp@umcg.nl.
authors.forename: Martine M
authors.initials: MM
authors.lastname: Goedendorp
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Clinical Research Office, UMC staff, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Daphne
authors.initials: D
authors.lastname: Kuiper
authors.affiliation: Department of Health Sciences, (Community & Occupational Medicine,) University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Sociology, University of Groningen, Groningen, The Netherlands.
authors.forename: Nardi
authors.initials: N
authors.lastname: Steverink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008132:Loneliness / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015397:Program Evaluation; D011615:Psychotherapy, Group; D011788:Quality of Life; D012648:Self Care / Q000379:methods* / Q000523:psychology; D000073278:Self-Management; D011795:Surveys and Questionnaires
keywords: Adherence; Aging and health; Dissemination and implementation; Integrity; Program fidelity; Reach; Self-management ability; Target group; Well-being