Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.
To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion.
Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, LE Tilburg, The Netherlands.|Regional Health Service, 'GGD Hart voor Brabant', 's-Hertogenbosch, The Netherlands.
Theo J M
TJM
Kuunders
Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, LE Tilburg, The Netherlands.|Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
Marja J H
MJH
van Bon-Martens
Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, LE Tilburg, The Netherlands.
Ien A M
IAM
van de Goor
TNO, Innovation for Life, Organization for Applied Scientific Research, Leiden, The Netherlands.
Theo G W M
TGWM
Paulussen
Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, LE Tilburg, The Netherlands.|National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Hans A M
HAM
van Oers
D019983:Guideline Adherence; D017408:Guidelines as Topic; D006284:Health Plan Implementation; D006291:Health Policy; D006296:Health Services; D006801:Humans; D009426:Netherlands; D011634:Public Health; D012040:Regional Health Planning