Tobacco control has been identified as the most urgent and immediate priority intervention to reduce the prevalence of non-communicable disease. Nevertheless, a substantial gap exists between the... Show moreTobacco control has been identified as the most urgent and immediate priority intervention to reduce the prevalence of non-communicable disease. Nevertheless, a substantial gap exists between the evidence-based knowledge on the treatment of tobacco dependence and real-world practices of primary care professionals. The empirical studies in this dissertation provided insight in a variety of methodological approaches that can be used to describe and facilitate the implementation of smoking cessation care in general practice. This resulted in study findings showing that a training programme for GPs including action planning has the potential to facilitate the implementation of smoking cessation care, in particular the degree to which smokers are identified and advised to quit. In addition, full health insurance coverage of stop-smoking programmes increased GP prescription behaviour. Yet, challenges remain to incorporate smoking cessation care as a routine procedure in general practice, with a special focus on arranging follow-up support by GPs. This dissertation provided several new ideas for future research in order to overcome these challenges. Multifaceted strategies, based on a socio-ecological approach to guideline implementation and including behavioural change theories, have the potential to facilitate a successful implementation of smoking cessation care in general practice. Show less
Diderich, H.M.; Dechesne, M.; Fekkes, M.; Verkerk, P.H.; Pannebakker, F.D.; Velderman, M.K.; ... ; Oudesluys-Murphy, A.M. 2014
The dissertation examines the application of EU farm animal welfare legislation in 27 member states. It develops a theoretical framework that applies insights from the transposition literature to... Show moreThe dissertation examines the application of EU farm animal welfare legislation in 27 member states. It develops a theoretical framework that applies insights from the transposition literature to the post-transposition phase of implementation and derives hypotheses to explain cross-national variation in implementation success. The hypotheses are centered on the notion that the pressure to adapt to EU requirements makes post-transposition application difficult. Countering adaptation pressure, the presence of discretion, whereby member states have some flexibility to adapt requirements to their national circumstances, helps to alleviate the difficulties brought on by adaptation pressure. Additional hypotheses are derived from the transposition literature concerning the geographic and organizational decentralization of implementation authority and the length of transposition delay prior to application. The hypotheses are tested through a mixed methods design that combines a set of case studies and a quantitative analysis of the implementation of all major requirements applied in 27 member states in the legislation within this policy area. Support is found for the adaptation pressure and discretion hypotheses, while limited support is found for the hypotheses concerning the decentralization of implementation authority Show less
Despite the promising findings related to the efficacy of primary health care-based physical activity interventions and recommendations for primary health care professionals to promote physical... Show moreDespite the promising findings related to the efficacy of primary health care-based physical activity interventions and recommendations for primary health care professionals to promote physical activity, the introduction of physical activity interventions in routine daily primary health care practice does not always happen as desired. Specifically, rates of physical activity promotion by primary health care professionals are far from optimal and physical activity interventions are not delivered as intended by the intervention developers. Knowledge of the factors that determine the success or failure of the introduction of innovations in health care is important for the development of strategies to improve the introduction process. As a first step towards the effective introduction of physical activity interventions in primary health care practice, the main aim of this thesis is to investigate what factors influence the introduction of physical activity interventions in primary health care. Show less
For a successful implementation of an educational reform, teachers need to regard the proposal as being practical. I used a modular, success-oriented approach to make a context-based reform... Show moreFor a successful implementation of an educational reform, teachers need to regard the proposal as being practical. I used a modular, success-oriented approach to make a context-based reform practical for implemtentation in Duthc biology education. educational reform, modular, teachers, biology, success-oriented, implementation, professional development Show less
NIPT is already clinically available in many countries, yet many research questions remain unanswered. In this thesis, important aspects for implementation are addressed. The main conclusions are... Show moreNIPT is already clinically available in many countries, yet many research questions remain unanswered. In this thesis, important aspects for implementation are addressed. The main conclusions are summarized below, followed by a discussion on future studies, future dreams and remaining research questions Show less
