Perceived facilitating and limiting factors for healthcare professionals to adopting a patient decision aid for breast cancer aftercare: A cross-sectional study

Linda A. Klaassen*, Jolanda H. H. M. Friesen-Storms, Gerrie J. J. W. Bours, Carmen D. Dirksen, Liesbeth J. Boersma, Ciska Hoving

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: Effective healthcare innovations are often not adopted and implemented. An implementation strategy based on facilitators and barriers for use as perceived by healthcare professionals could increase adoption rates. This study therefore aimed to identify the most relevant facilitators and barriers for use of an innovative breast cancer aftercare decision aid (PtDA) in healthcare practice.

Methods: Facilitators and barriers (related to the PtDA, adopter and healthcare organisation) were assessed among breast cancer aftercare health professionals (n = 81), using the MIDI questionnaire. For each category, a backward regression analysis was performed (dependent = intention to adopt). All significant factors were then added to a final regression analysis to identify to most relevant determinants of PtDA adoption.

Results: Expecting higher compatibility with daily practice and clinical guidelines, more positive outcomes of use, higher perceived relevance for the patient and increased self-efficacy were significantly associated with a higher intention to adopt. Self-efficacy and perceived patient relevance remained significant in the final model.

Conclusions: Low perceived self-efficacy and patient relevance are the most important barriers for health professions to adopt a breast cancer aftercare PtDA.

Practice implications: To target self-efficacy and perceived patient relevance, the implementation strategy could apply health professional peer champions. (c) 2019 Published by Elsevier B.V.

Original languageEnglish
Pages (from-to)145-151
Number of pages7
JournalPatient Education and Counseling
Issue number1
Publication statusPublished - Jan 2020


  • Intention to adopt
  • Patient decision aid
  • Breast cancer aftercare
  • Healthcare professionals

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