Met praktijkgericht onderzoek naar de implementatie van innovaties

This thesis is about the implementation of healthcare innovations in self-management emerging from practice-based research. Innovations to support self-management range from digital tools, such as eHealth applications, to health education programmes. Many self-management innovations fit within a specific context because, for example, they target people with certain health conditions. This context dependency means that many innovations are developed specifically for a particular practice or need to be adapted during implementation to fit the practice demand. Therefore, the operation of the innovation in a specific context deserves and requires further research during implementation. For research on the implementation of innovations in specific contexts, practice-based research is appropriate. Practice-based research is research that starts from a question from practice, seeks to provide a solution related to the practice context, and thereby equips professionals with knowledge and knowhow. With this, practice-based research contains a good basis for research in which implementation is part of the research process. However, innovating through (practice-based) research towards feasible and cost-effective improvements in care also proves difficult (Health Council, 2010; ZonMW, 2014). This dissertation studied how practice-based research can be used to contribute to the successful implementation of healthcare innovations in the field of self-management. The thesis answers the following research question: What are success factors in implementing healthcare innovations in self-management emerging from practice-based research? The four studies in this thesis collectively show five success factors that can contribute to the implementation of healthcare innovations in the field of self-management resulting from practice-based research. Researchers and students who want to achieve the implementation of innovations through practice-based research should: 1) Establish a reciprocal relationship with the end-users and stakeholders involved during (research) projects. 2) Be present in the practice context to live through the practice situation. 3) Explore solutions in the theoretical, conceptual and practice context. 4) Explore solutions in the practice context, testing the interaction of the innovation with the practice context and all specific features applicable there. 5) Demonstrate, transfer or deliver research results, prototypes and/or (interim) changes to individuals who can take follow-up steps so that the process remains focused on implementing an innovation in a specific practice. The Research Pathway Model (RPM) presented in this thesis provides a framework to deploy these success factors in a coherent way during (practice-based) research projects in which answers are given to a question from practice and in which the goal is to arrive at a solution for practice. In the RPM, the steps involving the delivery of theory, knowledge, prototypes and changes in practice are included as research steps. As the RPM has no prescribed sequence, these steps can also be the starting point of a research project. Practice-based research can also focus on how certain knowledge or theory is delivered, how a prototype develops into a market-ready product and/or how a change can be delivered in one or more practices.