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Table 3 Factors influencing the Salut Programme sustainability, nested in a theoretical scheme inspired by Grol and Wensing [16]*

From: Sustainable practice change: Professionals' experiences with a multisectoral child health promotion programme in Sweden

  FACTORS INFLUENCING SUSTAINABILITY
LEVEL REQUIREMENTS FACILITATORS BARRIERS
Innovation    
Development
process
  Involvement in development
and small scale testing 1-4
Support from process
consultants 1-4
Having time to develop
strategies 1-4
Time consuming and
ineffective 1-4
Content Carefully designed work
manuals 3
Perceived as important 1-4
Easily integrated 1-4
Manuals essential tools 1-4
Clear programme branding 1-4
Time consuming 1-4
Not suiting specific needs of
immigrants 1,2,4
Difficulty with social and
psychological problems 1,2
Found similar to approaches
already present at the work
place 1,2,4
Individual    
Professionals Own commitment and
interest 1-4
Own values coherent with
programme's purpose and
goals 1-4
Lack of motivation 2,3,4
Programme goals found
unrealistic 2
Parents
(Patients)
  Positive attitudes to
interventions 3,4
New topics and questionnaires
intrusive and extensive 1-3
Content of parent meetings
unpopular 1,3
Context    
Social Regular meetings 1-4
Permanent programme
organization 1-3
Information to new employees 1,3
Managerial responsibility
and commitment1-4
Regular meetings 1-4
Active managerial support 1-4
Lack of managerial
involvement or support 1-4
Lack of involvement or
support from physicians or
other colleagues 1-3
Organizational Programme integrated in
action plans 1-3
Geographical proximity for
collaborators 1-4
Sufficient time 1-3
Further establishment and
spread of the programme 1-4
Geographical proximity for
collaborators 1-4
Lack of time and resources 1-4
Lack of communication and
agreement between
programme management and
local managers 2,3
Economical
and political
Incentives in line with
programme intentions 3
  Conflicting incentives for
performance 3
Threat of cutbacks 1-3
  1. 1 Represent the views of midwives, 2 child health nurses, 3 dental hygienists/dental nurses, 4 open pre-school teachers
  2. * With an added level; development process.