ArticleBMC health services research2015
Implementation of evidence-based rehabilitation for non-specific back pain and common mental health problems: a process evaluation of a nationwide initiative.
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quantitative measures of health policy implementation determinants and outcomes: a systematic review.Implementation science : IS · 2020Pooled it
- Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM).BMC health services research · 2024Trial
- Implementation of care managers for patients with depression: a cross-sectional study in Swedish primary care.BMJ open · 2020Trial
- Article
- Implementation of cross-sectoral rehabilitation in the Nordic countries: a scoping review.Frontiers in health services · 2025Review
- Patient expectations and levels of satisfaction in chiropractic treatment for lumbar radiculopathy. A mixed methods study.Chiropractic & manual therapies · 2023Article
- International comparative study of low back pain care pathways and analysis of key interventions.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Heterogeneity in the associations between common mental disorders and labour outcomes - a population study from southern Sweden.BMC public health · 2020Article
- Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study.Primary health care research & development · 2020Observational
- Referring to multimodal rehabilitation for patients with musculoskeletal disorders - a register study in primary health care.BMC health services research · 2017Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNationwide implementation of guaranteed access to evidence-based rehabilitation was established in Sweden in 2009, through an Act of the Swedish Government. The rehabilitation guarantee's primary goal was to increase the rate of return-to-work, reduce and prevent long-term absenteeism after diagnoses related to back pain and common mental health problems. This study aims to develop knowledge about factors influencing large-scale implementation of complex and extensive interventions in healthcare settings.
methodsThree different data sources questionnaires, interviews and documents were used in data collection and analysis. The data were analysed using iterative thematic analysis.
resultsThe following main facilitators contributed to realization of the rehabilitation guarantee: financial incentives, establishment of project organization, recruitment, in-service training and previous experiences of working in similar projects. Barriers were: the rehabilitation guarantee's short-term project-form, clinicians' attitudes to and competence in working towards return-to-work, lack of guidelines describing treatment modalities in multimodal rehabilitation, and lack of well-defined criteria for inclusion of patients. Documents revealed that the return-to-work goal became less pronounced during the implementation process. Instead, care and health were more often described in documents used to disseminate information about the rehabilitation guarantee. Intermediate outcomes found were: patients with rehabilitation needs were given more adequate priority, increased readiness for future implementation efforts, and increased general competence in psychotherapy, and team-work, which thus became available to patient groups other than those covered by the rehabilitation guarantee.
conclusionsTo facilitate implementation of established national policy goals in clinical practice, tools are needed that specifically aim at changing clinicians' attitudes and behaviours in relation to such goals. Our results underline the importance of investing both time and sufficient resources in the activities and in supporting the implementation process.
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