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DOI: 10.1055/a-2255-1234
Mixed Methods-Ansätze zur Implementierung von Bewegung in der Tertiärprävention
Rationale, Anwendung und möglicher NutzenMixed Methods Approach For Implementing Physical Activity In Tertiary PreventionRationale, Application And Potential Benefits
Zusammenfassung
Es gibt umfangreiche Evidenz, dass Bewegung einen entscheidenden Beitrag zu Krankheitsprävention und Therapieerfolg leisten kann. Dennoch besteht in der Bevölkerung, besonders bei Patient*innen mit chronischen Erkrankungen, eine Lücke zwischen der vorhandenen Evidenz und der tatsächlichen Anwendung von Bewegung als Therapie, eine sogenannte „evidence-to-practice gap“.
Implementierungsforschung kann helfen, diese Lücken zu schließen, beispielsweise unter Verwendung theoretischer Frameworks. Der Einsatz von Mixed-Methods-Ansätzen (eine Kombination aus qualitativer und quantitativer Datenerhebung und -analyse) innerhalb dieser Frameworks ermöglicht ein umfassendes und tiefergehendes Verständnis von evidence-to-practice-gaps.
Daher sollte ihre Anwendung in Zukunft verstärkt werden, um evidence-to-practice-gaps in der Gesundheitsversorgung besser zu verstehen und zu überwinden und so eine optimale, patientenorientierte Versorgung sicherzustellen.
Summary
There is extensive evidence that physical activity can make a decisive contribution to disease prevention and therapeutic success. Nevertheless, in the population, especially among patients with chronic diseases, there is a gap between the available evidence and the actual use of exercise as therapy; the so-called “evidence-to-practice gap”. This gap can be filled by implementation research by e. g., using theoretical frameworks. The use of mixed-methods approaches (a combination of qualitative and quantitative data collection and analysis) within these frameworks enables a comprehensive and in-depth understanding of evidence-to-practice gap. Mixed-methods should thus be increasingly employed in future research in order to better understand and overcome evidence-to-practice gaps in healthcare and thus ensure optimal, patient-centred care.
Publication History
Received: 22 December 2023
Accepted after revision: 11 January 2024
Article published online:
09 April 2024
© 2024. Thieme. All rights reserved.
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Literatur
- 1 Arndt K-H, Löllgen H, Schnell D. et al. Hrsg. 100 Jahre Deutsche Sportmedizin: Sportmedizin im Wandel – Wandel durch Sportmedizin; mit 15 Tabellen. Gera: Druckhaus Verl. Gera. 2012
- 2 Tipton CM. The history of “Exercise Is Medicine” in ancient civilizations. Advances in Physiology Education 2014; 38: 109-117 DOI: 10.1152/advan.00136.2013.
- 3 Füzéki E, Vogt L, Banzer W. Nationale Bewegungsempfehlungen für Erwachsene und ältere Erwachsene – Methodisches Vorgehen, Datenbasis und Begründung. Gesundheitswesen 2017; 79: S20-S28 DOI: 10.1055/s-0042-123700.
- 4 Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015; 25: 1-72 DOI: 10.1111/sms.12581.
- 5 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Mammakarzinoms, Version 4.4, 2021, AWMF Registernummer: 032-045OL, http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom/(abgerufen am: 26.11.2023)
- 6 Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer 2015; 15: 77 DOI: 10.1186/s12885-015-1069-4.
- 7 McDonagh TA, Metra M, Adamo M. et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal 2021; 42: 3599-3726 DOI: 10.1093/eurheartj/ehab368.
- 8 World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018
- 9 World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020
- 10 Krug S, Jordan S, Mensink GBM. et al. Körperliche Aktivität: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 2013; 56: 765-771 DOI: 10.1007/s00103-012-1661-6.
- 11 Thompson WR, Sallis R, Joy E. et al. Exercise Is Medicine. American Journal of Lifestyle Medicine 2020; 14: 511-523 DOI: 10.1177/1559827620912192.
- 12 Sallis R. Exercise is medicine: a call to action for physicians to assess and prescribe exercise. The Physician and Sportsmedicine 2015; 43: 22-26 DOI: 10.1080/00913847.2015.1001938.
- 13 Bouma A, van Nassau F, Nauta J. et al. Implementing Exercise = Medicine in routine clinical care; needs for an online tool and key decisions for implementation of Exercise = Medicine within two Dutch academic hospitals. BMC Med Inform Decis Mak 2022; 22: 250 DOI: 10.1186/s12911-022-01993-5.
- 14 Pelliccia A, Sharma S, Gati S. et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. European Heart Journal 2021; 42: 17-96 DOI: 10.1093/eurheartj/ehaa605.
- 15 Hayes SC, Newton RU, Spence RR. et al. The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management. J Sci Med Sport 2019; 22: 1175-1199 DOI: 10.1016/j.jsams.2019.05.003.
- 16 Nauta J, van Nassau F, Bouma AJ. et al. Facilitators and barriers for the implementation of exercise are medicine in routine clinical care in Dutch university medical centres: a mixed methodology study on clinicians’ perceptions. BMJ Open 2022; 12: e052920 DOI: 10.1136/bmjopen-2021-052920.
- 17 Kennedy MA, Bayes S, Newton RU. et al. Implementation barriers to integrating exercise as medicine in oncology: an ecological scoping review. J Cancer Surviv 2022; 16: 865-881 DOI: 10.1007/s11764-021-01080-0.
- 18 Kitson A, Straus SE. The knowledge-to-action cycle: identifying the gaps. Canadian Medical Association Journal 2010; 182: E73-E77 DOI: 10.1503/cmaj.081231.
- 19 Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. The Lancet 2003; 362: 1225-1230 DOI: 10.1016/S0140-6736(03)14546-1.
- 20 Moullin JC, Sabater-Hernández D, Fernandez-Llimos F. et al. A systematic review of implementation frameworks of innovations in healthcare and resulting generic implementation framework. Health Res Policy Sys 2015; 13: 16 DOI: 10.1186/s12961-015-0005-z.
- 21 Brownson RC, Colditz GA, Proctor EK. Hrsg. Dissemination and implementation research in health: translating science to practice. Third edition. New York, NY: Oxford University Press; 2023
- 22 Glasgow RE, Harden SM, Gaglio B. et al. RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review. Front Public Health 2019; 7: 64 DOI: 10.3389/fpubh.2019.00064.
- 23 Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 1999; 89: 1322-1327 DOI: 10.2105/AJPH.89.9.1322.
- 24 Holtrop JS, Estabrooks PA, Gaglio B. et al. Understanding and applying the RE-AIM framework: Clarifications and resources. J Clin Trans Sci 2021; 5: e126 DOI: 10.1017/cts.2021.789.
- 25 Hodgson W, Kirk A, Lennon M. et al. RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Evaluation of the Use of Activity Trackers in the Clinical Care of Adults Diagnosed With a Chronic Disease: Integrative Systematic Review. J Med Internet Res 2023; 25: e44919 DOI: 10.2196/44919.
- 26 Palinkas LA, Aarons GA, Horwitz S. et al. Mixed Method Designs in Implementation Research. Adm Policy Ment Health 2011; 38: 44-53 DOI: 10.1007/s10488-010-0314-z.
- 27 Timans R, Wouters P, Heilbron J. Mixed methods research: what it is and what it could be. Theor Soc 2019; 48: 193-216 DOI: 10.1007/s11186-019-09345-5.
- 28 Pluye P, Hong QN. Combining the Power of Stories and the Power of Numbers: Mixed Methods Research and Mixed Studies Reviews. Annu Rev Public Health 2014; 35: 29-45 DOI: 10.1146/annurev-publhealth-032013-182440.
- 29 Rutherford Z, Zwolinsky S, Kime N. et al. A Mixed-Methods Evaluation of CARE (Cancer and Rehabilitation Exercise): A Physical Activity and Health Intervention, Delivered in a Community Football Trust. IJERPH 2021; 18: 3327 DOI: 10.3390/ijerph18063327.
- 30 Kennedy MA, Bayes S, Galvão DA. et al. If you build it, will they come? Evaluation of a co-located exercise clinic and cancer treatment centre using the RE-AIM framework. Eur J Cancer Care (Engl) 2020; 29: e13251 DOI: 10.1111/ecc.13251.
- 31 Wasti SP, Simkhada P, van Teijlingen ER. et al. The Growing Importance of Mixed-Methods Research in Health. Nepal J Epidemiol 2022; 12: 1175-1178 DOI: 10.3126/nje.v12i1.43633.
- 32 Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet 2003; 362: 1225-1230 DOI: 10.1016/S0140-6736(03)14546-1.