Feasibility and Acceptability of an Implementation Strategy Bundle To Implement a Lifestyle Intervention in Community-care

Abstract Background ProMuscle is an evidence-based lifestyle intervention for community-dwelling older adults, combining exercise and nutrition. This pilot study investigated the feasibility, acceptability, and fidelity of a recently developed Implementation Strategy Bundle to facilitate the implementation of ProMuscle in seven community-care settings in the Netherlands. Method This mixed-methods study followed an exploratory sequential approach. Eight physical therapists and three dieticians received the Implementation Strategy Bundle, which contain chronologically described activities targeting the two most prevalent barriers ‘knowledge’ and ‘costs’. Quantitative data were collected through surveys at baseline, 3 months and 8 months post-implementation. A process evaluation consisted of monthly project meetings and a 90-minute focusgroup, 8 months post-implementation. Quantitative data were statistically analyzed and informed the interview guide of the focus group. Field notes, memos and transcript of the focusgroup were thematically analyzed. Results Quantitative results showed that the Implementation Strategy Bundle was acceptable (4.31 ± 0.54, 5-point Likert scale) and feasible (4.61 ± 0.42). Most activities were executed as proposed, indicating good fidelity. The process evaluation indicated the strategy bundle as helpful and easy to use, with suggestions for improvement. Low recruitment rates and a long start-up were barriers that surfaced during the study and resulted in only 13 older adults participating in ProMuscle. Activities to enhance collaboration are suggested to overcome these barriers. Conclusion This study showed that the Implementation Strategy Bundle addressing barriers on knowledge and costs is feasible and acceptable for facilitating the implementation of ProMuscle in multiple community-care settings. Suggestions from this pilot should be considered before investigating the effectiveness in a larger trail.