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Table 3 Overview of findings

From: Exploring drivers and challenges in implementation of health promotion in community mental health services: a qualitative multi-site case study using Normalization Process Theory

Coherence
• Existing understandings of health and health promotion
• Perceived connections to existing goals and practices
SLIPS perceived as meaningful across providers
• Based on broad understanding of health related to what gave physical and mental well-being
• Integral component of ‘recovery’ as predominant treatment approach; Continuity with other health promotion initiatives had ambivalent impact
Cognitive Participation
• Engagement in implementation process
• Engagement of management varied; From integrated and continuous involvement to decoupled and ad hoc
• Engagement of staff was an important challenge; Some did not buy into the concept of being role models
Collective action
• Enactment of the intervention: Approach to working with health promotion
• Importance of user and staff resources
• Approach of ‘gentle motivation’ across providers
• Enacting the intervention in interactions with users was challenging due to the heterogeneous user group with complex circumstances and needs; Required high level of staff engagement and flexibility
Reflexive monitoring
• On-going monitoring and adjustment of health promotion activities
• Informal, ad hoc monitoring and adjustment of activities predominant across providers