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Table 2 Facilitating and impeding factors for each domain

From: The implementation of the coaching on lifestyle (CooL) intervention: lessons learnt

Domain Facilitating factors Impeding factors
Lifestyle coaches - High level of work engagement
- Empathising with others
- Good contacts and getting along with the participants
- High involvement
- Great enthusiasm
- Openness
- Supporting instead of directing participants
- Patience
- Confidence in participants
- Knowledge and skills regarding systematic behaviour change
- Lack of entrepreneurship
- Lack of networking skills
- Not using the professional network for referring
Inner setting - Having project groups
- Locations in the neighbourhood
- Support from the health care centre
- Cooperation between the LSCs
- No appropriate financial compensation for lifestyle coaches
- Too many unpaid administrative tasks for lifestyle coaches
Outer setting
Participants - Low drop-out rates
- Intrinsic motivation to change before the start
- High self-efficacy to change
- History of multiple failures in trying to lose weight
- Having other more important problems decreases motivation
- Financial problems
- Sense of not fitting in with the group
- Unsupportive parents regarding changing their child’s lifestyle
Referrers - Personal motivation of referrers
- Referrers’ knowledge of and experience with lifestyle coaching and the coaches
- Perceived lack of time or priority to be involved in the programme
- Some referrers knew too little about the programme
Context - Expected future coverage of CLIs by health insurance
- Collaborating with other partners and different disciplines
- Increased familiarity with the lifestyle coaches and their role
- Health care professional’s unawareness about their role in lifestyle change
Implementation process
Planning - Involvement of stakeholders in project groups - Too little time for implementation to create support among the referrers
Engaging - Creating support
- Kick-off meetings
- Protocols for lifestyle coaches and referrers
- Not having the logistics organised at the start of the implementation
Executing - Effective communication and collaboration between lifestyle coaches and referrers
- Attending more meetings to inform the referrers
- Articles in local newspapers
- Time investment for lifestyle coaches, stakeholders and participants
- Too few personal contacts with referrers
- Lack of clear communication materials
Reflecting and evaluating - Most participants were satisfied
- Ensuring well-organised preconditions
- Having suitable manuals for new lifestyle coaches
- Too heterogeneous groups and large differences between participants
- Too much time between contact moments, and between registration and start of the group
- Too few individual coaching sessions (for children)
- No ambassador in every region
 CooL intervention - Frequent contacts over a period of six months
- Optimised combination of individual and group sessions
- Not only focusing on nutrition, but multiple themes including stress and sleep
- Learning from peers
- Whole family takes part in the children’s programme
- Home visits for children
- Participant-centred approach
- Positive approach aimed at increasing autonomous motivation
- Knowledge transfer and practical implications for daily life
- Approach tailored to the participants’ needs
- Flexibility in design and content
- Easily accessible for participants
- No charge for participants
- Inadequate time slots for group sessions
- Strict inclusion criteria
- Participant materials with too much text
- Materials not suitable for non-Dutch speaking persons