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dc.contributor.authorDaw, P
dc.contributor.authorWood, GER
dc.contributor.authorHarrison, A
dc.contributor.authorDoherty, PJ
dc.contributor.authorVeldhuijzen van Zanten, JJCS
dc.contributor.authorDalal, HM
dc.contributor.authorTaylor, RS
dc.contributor.authorvan Beurden, SB
dc.contributor.authorMcDonagh, STJ
dc.contributor.authorGreaves, CJ
dc.date.accessioned2022-09-05T13:48:00Z
dc.date.issued2022-07-13
dc.date.updated2022-09-05T12:54:24Z
dc.description.abstractOBJECTIVES: This study aimed to identify barriers to, and facilitators of, implementation of the Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme within existing cardiac rehabilitation services, and develop and refine the REACH-HF Service Delivery Guide (an implementation guide cocreated with healthcare professionals). REACH-HF is an effective and cost-effective 12-week home-based cardiac rehabilitation programme for patients with heart failure. SETTING/PARTICIPANTS: In 2019, four early adopter 'Beacon Sites' were set up to deliver REACH-HF to 200 patients. In 2020, 5 online REACH-HF training events were attended by 85 healthcare professionals from 45 National Health Service (NHS) teams across the UK and Ireland. DESIGN: Our mixed-methods study used in-depth semi-structured interviews and an online survey. Interviews were conducted with staff trained specifically for the Beacon Site project, identified by opportunity and snowball sampling. The online survey was later offered to subsequent NHS staff who took part in the online REACH-HF training. Normalisation Process Theory was used as a theoretical framework to guide data collection/analysis. RESULTS: Seventeen healthcare professionals working at the Beacon Sites were interviewed and 17 survey responses were received (20% response rate). The identified barriers and enablers included, among many, a lack of resources/commissioning, having interest in heart failure and working closely with the clinical heart failure team. Different implementation contexts (urban/rural), timing (during the COVID-19 pandemic) and factors outside the healthcare team/system (quality of the REACH-HF training) were observed to negatively or positively impact the implementation process. CONCLUSIONS: The findings are highly relevant to healthcare professionals involved in planning, delivering and commissioning of cardiac rehabilitation for patients with heart failure. The study's main output, a refined version of the REACH-HF Service Delivery Guide, can guide the implementation process (eg, designing new care pathways) and provide practical solutions to overcoming common implementation barriers (eg, through early identification of implementation champions).en_GB
dc.format.extente060221-
dc.format.mediumElectronic
dc.identifier.citationVol. 12(7), article e060221en_GB
dc.identifier.doihttps://doi.org/10.1136/bmjopen-2021-060221
dc.identifier.urihttp://hdl.handle.net/10871/130674
dc.identifierORCID: 0000-0002-7316-7544 (Dalal, Hasnain M)
dc.identifierORCID: 0000-0001-7848-2159 (van Beurden, Samantha B)
dc.identifierScopusID: 57163393500 (van Beurden, Samantha B)
dc.identifierORCID: 0000-0002-0283-3095 (McDonagh, Sinead TJ)
dc.language.isoenen_GB
dc.publisherBMJ Publishing Groupen_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/35831041en_GB
dc.rights© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.en_GB
dc.titleBarriers and facilitators to implementation of a home-based cardiac rehabilitation programme for patients with heart failure in the NHS: a mixed-methods studyen_GB
dc.typeArticleen_GB
dc.date.available2022-09-05T13:48:00Z
dc.identifier.issn2044-6055
exeter.article-numberARTN e060221
exeter.place-of-publicationEngland
dc.descriptionThis is the final version. Available on open access from BMJ Publishing Group via the DOI in this recorden_GB
dc.descriptionData availability statement: Data are available on reasonable request. The datasets analysed during the current study are available from the corresponding author on reasonable request.en_GB
dc.identifier.eissn2044-6055
dc.identifier.journalBMJ Openen_GB
dc.relation.ispartofBMJ Open, 12(7)
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/en_GB
dcterms.dateAccepted2022-06-29
dc.rights.licenseCC BY-NC
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2022-07-13
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2022-09-05T13:46:26Z
refterms.versionFCDVoR
refterms.dateFOA2022-09-05T13:48:28Z
refterms.panelAen_GB
refterms.dateFirstOnline2022-07-13


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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Except where otherwise noted, this item's licence is described as © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.