A mixed methods process evaluation of the implementation of a peer coaching intervention to improve the execution of preventive tasks by occupational physicians

采用混合方法对同伴辅导干预措施的实施情况进行过程评估,以提高职业医师执行预防性任务的能力。

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Abstract

OBJECTIVES: This study aimed to evaluate the process of implementation of a peer coaching intervention program for occupational physicians (OPs) to improve the execution of preventive tasks. Specifically, the evaluation seeks to: (1) describe the reach and uptake of the intervention program; (2) determine the extent to which the program was implemented as intended; (3) provide insights into experiences of OPs, and (4) identify factors influencing the implementation. METHODS: This study employed a mixed-methods design. To address the four research aims, seven process indicators were used: acceptability, adoption, appropriateness, feasibility, fidelity, penetration and sustainability. Data were collected between March and June 2024 by means of an online questionnaire (N = 98), and 17 semi-structured interviews with group coordinators and OPs. The questionnaire included questions on attendance and reasons for non-attendance, experiences, and ratings of several aspects of the intervention program. Interviews focused on why and how OPs participated, experiences with the intervention program and how it can be improved, and how attention to prevention can be sustained. RESULTS: Reach and uptake: 20 out of 21 groups allocated to the intervention program participated in the intervention and 98 out of 115 participants (85%) filled in the questionnaire. Three-quarters of the participants completed the entire program. Implementation as intended: 96% of the OPs successfully discussed barriers to the execution of preventive tasks, and 83% were able to formulate strategies for these barriers. Barriers and facilitators: Most participants managed to implement their formulated goals in practice. When they were unable to do so, time constraints and resistance from employers and their occupational health services often played a role. Participants' experiences: OPs valued the program's structure, interaction with colleagues, and the increased awareness it generated. DISCUSSION AND CONCLUSION: The peer coaching group program was well-implemented and positively evaluated by OPs. The program can be improved by allocating more time to it, for instance by integrating it into the educational curriculum, and by paying more attention to the specific working conditions of OPs, such as the different sectors in which they are employed. TRIAL REGISTRATION: ISRCTN registry; ISRCTN15394765. Registered on 27 June 2023.

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