JMIR Publications

ABSTRACT

Background:

Despite its potential to address key challenges in primary health care, digital health measurement faces substantial implementation barriers for health care professionals. To address these barriers, professionals from 4 disciplines - physical therapy, occupational therapy, speech and language therapy, and general practitioner practice assistance – collaborated with researchers to develop an intervention. The intervention comprised a website supported by coaching on the job as a temporary implementation strategy during development.

Objective:

This study explored whether and how the intervention facilitates optimized use of digital health measurement in patient care to inform further intervention refinement.

Methods:

A mixed-methods formative process evaluation was conducted using a predominantly qualitative approach. 18 health care professionals tested the intervention in daily practice. Data collection was guided by the Medical Research Council framework, a predefined process evaluation plan, and the intervention’s initial program theory. Quantitative data (questionnaires, 7-point Global Perceived Effect measures, and monitoring lists) informed semi-structured interviews and focus groups. Data were analyzed using descriptive statistics and directed content analysis.

Results:

The intervention was largely implemented as intended and improved digital health measurement in patient care by enhancing participants’ capability, opportunity, and motivation. Consistent with the initial program theory, these changes triggered implementation activity at the organizational level, strengthening implementation readiness through bottom-up change processes. Intervention strategies included collaborative learning, modelling and prompting action. These strategies operated through mechanisms such as experiential learning, in which professionals experienced the benefits and feasibility of digital health measurement, reinforcing motivation for its continued use. During intervention use, additional processes emerged, including champions facilitating organizational-level adoption of digital measurement by sharing knowledge and enthusiasm with colleagues. Coaching particularly supported initial intervention engagement by contextualizing generic information, stimulating interaction, and prompting action. Individual, organizational, instrumental, temporal, policy, and societal factors interacted with intervention components, strategies, and mechanisms to facilitate or constrain outcomes.

Conclusions:

Future refinement should strengthen key mechanisms and processes, integrate mechanisms previously supported by coaching, and develop scalable implementation strategies. As no single approach will fit all contexts, practices should tailor implementation to their local needs. The intervention’s generic framework and flexible use of core components support local adaptations.