Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation
Abstract Background Osteoporosis patient education is offered in many countries worldwide. When evaluating complex interventions like these, it is important to understand how and why the intervention leads to effects. This study aimed to develop a program theory of osteoporosis patient education in...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-04957-8 |
| _version_ | 1797199230297702400 |
|---|---|
| author | Mette Rubæk Marie Broholm-Jørgensen Susan Andersen Pernille Ravn Jakobsen Mette Juel Rothmann Bente Langdahl Mette Friberg Hitz Teresa Holmberg |
| author_facet | Mette Rubæk Marie Broholm-Jørgensen Susan Andersen Pernille Ravn Jakobsen Mette Juel Rothmann Bente Langdahl Mette Friberg Hitz Teresa Holmberg |
| author_sort | Mette Rubæk |
| collection | DOAJ |
| description | Abstract Background Osteoporosis patient education is offered in many countries worldwide. When evaluating complex interventions like these, it is important to understand how and why the intervention leads to effects. This study aimed to develop a program theory of osteoporosis patient education in Danish municipalities with a focus on examining the mechanisms of change i.e. what is about the programs that generate change. Methods The program theory was developed in an iterative process. The initial draft was based on a previous published systematic review, and subsequently the draft was continually refined based on findings from observations (10 h during osteoporosis patient education) and interviews (individual interviews with six employees in municipalities and three health professionals at hospitals, as well as four focus group interviews with participants in patient education (in total 27 informants)). The transcribed interviews were analyzed using thematic analysis and with inspiration from realist evaluation the mechanisms as well as the contextual factors and outcomes were examined. Results Based on this qualitative study we developed a program theory of osteoporosis patient education and identified four mechanisms: motivation, recognizability, reassurance, and peer reflection. For each mechanism we examined how contextual factors activated the mechanism as well as which outcomes were achieved. For instance, the participants’ motivation is activated when they meet in groups, and thereafter outcomes such as more physical activity may be achieved. Recognizability is activated by the participants’ course of disease, which may lead to better ergonomic habits. Reassurance may result in more physical activity, and this mechanism is activated in newly diagnosed participants without previous fractures. Peer reflection is activated when the participants meet in groups, and the outcome healthier diet may be achieved. Conclusions We developed a program theory and examined how and why osteoporosis patient education is likely to be effective. Understanding these prerequisites is important for future implementation and evaluation of osteoporosis patient education. |
| first_indexed | 2024-04-24T07:12:27Z |
| format | Article |
| id | doaj.art-f6685fe743254e3db4e5bb547330e609 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-24T07:12:27Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-f6685fe743254e3db4e5bb547330e6092024-04-21T11:29:32ZengBMCBMC Geriatrics1471-23182024-04-0124111810.1186/s12877-024-04957-8Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluationMette Rubæk0Marie Broholm-Jørgensen1Susan Andersen2Pernille Ravn Jakobsen3Mette Juel Rothmann4Bente Langdahl5Mette Friberg Hitz6Teresa Holmberg7National Institute of Public Health, University of Southern DenmarkNational Institute of Public Health, University of Southern DenmarkNational Institute of Public Health, University of Southern DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern DenmarkSteno Diabetes Center Odense, Odense University HospitalDepartment of Endocrinology, Aarhus University HospitalNational Research Center for Bone Health, Zealand University HospitalCentre for Childhood HealthAbstract Background Osteoporosis patient education is offered in many countries worldwide. When evaluating complex interventions like these, it is important to understand how and why the intervention leads to effects. This study aimed to develop a program theory of osteoporosis patient education in Danish municipalities with a focus on examining the mechanisms of change i.e. what is about the programs that generate change. Methods The program theory was developed in an iterative process. The initial draft was based on a previous published systematic review, and subsequently the draft was continually refined based on findings from observations (10 h during osteoporosis patient education) and interviews (individual interviews with six employees in municipalities and three health professionals at hospitals, as well as four focus group interviews with participants in patient education (in total 27 informants)). The transcribed interviews were analyzed using thematic analysis and with inspiration from realist evaluation the mechanisms as well as the contextual factors and outcomes were examined. Results Based on this qualitative study we developed a program theory of osteoporosis patient education and identified four mechanisms: motivation, recognizability, reassurance, and peer reflection. For each mechanism we examined how contextual factors activated the mechanism as well as which outcomes were achieved. For instance, the participants’ motivation is activated when they meet in groups, and thereafter outcomes such as more physical activity may be achieved. Recognizability is activated by the participants’ course of disease, which may lead to better ergonomic habits. Reassurance may result in more physical activity, and this mechanism is activated in newly diagnosed participants without previous fractures. Peer reflection is activated when the participants meet in groups, and the outcome healthier diet may be achieved. Conclusions We developed a program theory and examined how and why osteoporosis patient education is likely to be effective. Understanding these prerequisites is important for future implementation and evaluation of osteoporosis patient education.https://doi.org/10.1186/s12877-024-04957-8OsteoporosisPatient educationProgram theoryMechanism of change |
| spellingShingle | Mette Rubæk Marie Broholm-Jørgensen Susan Andersen Pernille Ravn Jakobsen Mette Juel Rothmann Bente Langdahl Mette Friberg Hitz Teresa Holmberg Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation BMC Geriatrics Osteoporosis Patient education Program theory Mechanism of change |
| title | Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation |
| title_full | Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation |
| title_fullStr | Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation |
| title_full_unstemmed | Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation |
| title_short | Development of a program theory for osteoporosis patient education in Denmark: a qualitative study based on realist evaluation |
| title_sort | development of a program theory for osteoporosis patient education in denmark a qualitative study based on realist evaluation |
| topic | Osteoporosis Patient education Program theory Mechanism of change |
| url | https://doi.org/10.1186/s12877-024-04957-8 |
| work_keys_str_mv | AT metterubæk developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT mariebroholmjørgensen developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT susanandersen developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT pernilleravnjakobsen developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT mettejuelrothmann developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT bentelangdahl developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT mettefriberghitz developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation AT teresaholmberg developmentofaprogramtheoryforosteoporosispatienteducationindenmarkaqualitativestudybasedonrealistevaluation |