Implementation factors affecting the large-scale deployment of digital health and well-being technologies: A qualitative study of the initial phases of the 'Living-It-Up' programme.
Implementation factors affecting the large-scale deployment of digital health and well-being technologies: A qualitative study of the initial phases of the 'Living-It-Up' programme.
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DOI：
10.1177/1460458215594651
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发表时间：
2016-12
影响因子：
3
通讯作者：
Mair FS
中科院分区：
文献类型：
--
作者：
Agbakoba R;McGee-Lennon M;Bouamrane MM;Watson N;Mair FS
人们对促进或阻碍大规模部署保健和福祉消费技术的因素知之甚少。Living-It-Up项目是由NHS 24领导的大规模数字干预项目，旨在改变整个苏格兰的健康和福祉服务交付。我们对影响生活服务实施和部署的因素进行了定性研究。我们在部署的初始阶段收集了一系列数据，包括半结构化访谈(N=6)、参与者观察会(N=5)和与关键利益攸关方的会议(N=3)。我们使用正常化过程理论作为解释框架，来解释在部署的初始阶段发挥作用的社会过程。初步调查结果表明，−很清楚，但或许并不令人惊讶的是，Living-It-Up联合体的规模和多样性使“多方利益相关者”环境中的实施过程更加复杂。为了克服这些障碍，有必要明确界定财团合作伙伴之间的角色、任务和责任。此外，必须有效管理不同程度的期望和要求，以及不同的文化和工作方式。促进实施的因素包括利益攸关方的广泛参与，例如共同设计活动，从长远来看，这可能有助于增加用户的‘买入’。Living-It-Up倡议的一个重要教训是，试图共同设计创新的数字服务，但同时招募大量用户可能会产生相互冲突的实施优先事项，从而阻碍−或至少大幅减缓−有效推出大规模服务的速度。Living-It-Up服务的部署正在进行中，但我们迄今的结果表明，−为了成功地大规模推出数字健康和福祉技术，需要在共同设计活动、创新服务的开发以及分配给广泛的营销和招聘举措的努力之间进行微妙和务实的权衡。
Little is known about the factors which facilitate or impede the large-scale deployment of health and well-being consumer technologies. The Living-It-Up project is a large-scale digital intervention led by NHS 24, aiming to transform health and well-being services delivery throughout Scotland. We conducted a qualitative study of the factors affecting the implementation and deployment of the Living-It-Up services. We collected a range of data during the initial phase of deployment, including semi-structured interviews (N = 6); participant observation sessions (N = 5) and meetings with key stakeholders (N = 3). We used the Normalisation Process Theory as an explanatory framework to interpret the social processes at play during the initial phases of deployment. Initial findings illustrate that it is clear − and perhaps not surprising − that the size and diversity of the Living-It-Up consortium made implementation processes more complex within a ‘multi-stakeholder’ environment. To overcome these barriers, there is a need to clearly define roles, tasks and responsibilities among the consortium partners. Furthermore, varying levels of expectations and requirements, as well as diverse cultures and ways of working, must be effectively managed. Factors which facilitated implementation included extensive stakeholder engagement, such as co-design activities, which can contribute to an increased ‘buy-in’ from users in the long term. An important lesson from the Living-It-Up initiative is that attempting to co-design innovative digital services, but at the same time, recruiting large numbers of users is likely to generate conflicting implementation priorities which hinder − or at least substantially slow down − the effective rollout of services at scale. The deployment of Living-It-Up services is ongoing, but our results to date suggest that − in order to be successful − the roll-out of digital health and well-being technologies at scale requires a delicate and pragmatic trade-off between co-design activities, the development of innovative services and the efforts allocated to widespread marketing and recruitment initiatives.