The Challenge of Changing Practice Applying Theory in the Implementation of an Innovation in Swedish Primary Health Care

.................................................................................................................. 1 LIST OF PAPERS ........................................................................................................ 3 TERMS AND CONCEPTS ........................................................................................ 5 INTRODUCTION ....................................................................................................... 7 BACKGROUND .......................................................................................................... 9 Overview of implementation research ............................................................ 9 Research traditions ......................................................................................... 9 Models and frameworks for implementation ........................................... 12 The use of theory in implementation research ......................................... 16 Lifestyle intervention in primary health care .............................................. 16 Computer-based interventions ................................................................... 19 The computer-based lifestyle intervention tool .......................................... 19 Culture and sub-cultures in health care organizations .............................. 21 THEORETICAL FRAMEWORK ............................................................................ 23 The innovation-decision process .................................................................... 23 The RE-AIM framework ................................................................................... 24 A synthesized implementation model ........................................................... 24 The context ..................................................................................................... 25 The adopters .................................................................................................. 26 The implementation activities ..................................................................... 27 The innovation .............................................................................................. 28 Interdependency between the factors ........................................................ 29 Sustainability ...................................................................................................... 30