@文章{info:doi/ 10.296 /10768，作者="Ware, Patrick和Ross, Heather J和Cafazzo, Joseph A和Laporte, Audrey和Gordon, Kayleigh和Seto, Emily"，标题="评估基于手机的远程监控项目的实施:实施研究统一框架指导下的纵向研究"，期刊="JMIR Mhealth Uhealth"，年="2018"，月="7"，日="31"，卷="6"，数="7"，页="e10768"，关键词="实施研究统一框架;电子健康;心力衰竭;实施;背景:远程监测在减轻个人和卫生系统心力衰竭负担方面显示出了前景。然而，可持续的项目在现实世界的实施是罕见的。目的:本研究的目的是通过回答两个研究问题来评估基于手机的远程监测项目的实施情况，该项目已在一家心功能专科诊所作为标准护理的一部分实施。(1)远程监测项目成功实施的程度如何?(2)实施远程监测项目的障碍和促进因素是什么?方法:我们进行了纵向单例研究。使用以下四个实施结果来评估实施的成功:采用、渗透、可行性和保真度。 Semistructured interviews based on the Consolidated Framework for Implementation Research (CFIR) were conducted at 0, 4, and 12 months with 12 program staff members to identify the barriers and facilitators of the implementation. Results: One year after the implementation, 98 patients and 8 clinicians were enrolled in the program. Despite minor technical issues, the intervention was used as intended. We obtained qualitative data from clinicians (n=8) and implementation staff members (n=4) for 24 CFIR constructs. A total of 12 constructs were facilitators clustered in the CFIR domains of inner setting (culture, tension for change, compatibility, relative priority, learning climate, leadership engagement, and available resources), characteristics of individuals (knowledge and beliefs about the intervention and self-efficacy), and process (engaging and reflecting and evaluating). In addition, we identified other notable facilitators from the characteristics of the intervention domain (relative advantage and adaptability) and the outer setting (patient needs and resources). Four constructs were perceived as minor barriers--- the complexity of the intervention, cost, inadequate communication among high-level stakeholders, and the absence of a formal implementation plan. The remaining CFIR constructs had a neutral impact on the overall implementation. Conclusions: This is the first comprehensive evaluation of the implementation of a mobile phone--based telemonitoring program. Although the acceptability of the telemonitoring system was high, the strongest facilitators to the implementation success were related to the implementation context. By identifying what works and what does not in a real-world clinical context using a framework-guided approach, this work will inform the design of telemonitoring services and implementation strategies of similar telemonitoring interventions. ", issn="2291-5222", doi="10.2196/10768", url="http://mhealth.www.mybigtv.com/2018/7/e10768/", url="https://doi.org/10.2196/10768", url="http://www.ncbi.nlm.nih.gov/pubmed/30064970" }