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Table 2 Overview of themes and main results by clients and health care professionals

From: Implementation of a lifestyle intervention for people with a severe mental illness (SMILE): a process evaluation




Healthcare professionals

1) Positive appraisal of the SMILE intervention

Clients enjoyed participating in the SMILE intervention

Clients perceived the intervention as useful, motivating and enjoyable. Clients had positive experiences with HCPs involved with SMILE.

Not applicable

HCPs enjoyed conducting the SMILE intervention

Not applicable

HCPs enjoyed conducting the intervention and seeing positive results in clients.

2) Suggestions for improvement of the SMILE intervention

Tailoring the SMILE intervention to people with SMI

Not applicable

HCPs find the intervention suitable and interesting for all people with SMI. However, tailoring for the individual characteristics of patients is needed.

No consensus on frequency of sessions of the SMILE intervention

Transition from weekly to monthly sessions is too big, however monthly sessions can have some benefits.

Believe transition from weekly to monthly sessions is too big, however workload was better during monthly sessions.

3) Facilitators of implementation

User-friendly handbook

Not applicable

Handbook was user friendly and provided detailed information which supported HCPs in conducting the intervention.

Training of HCPs

Not applicable

Information regarding nutrition and other lifestyle related subjects were found important to learn during training.

4) Barriers of implementation

SMILE in combination with usual work

Not applicable

It was difficult to combine the SMILE activities with daily tasks. In order to conduct the intervention it is needed for (at least) two HCPs to be involved with SMILE in order to align work activities between HCPs. More time is needed to conduct the intervention.

Lack of team and management support during implementation

A change in HCPs had a negative influence on the cohesion within the group.

In most teams HCPs felt no support from their other team members. They feel SMILE should be more of a priority within teams or management. A shortage of staff in general had a negative influence on the workload of HCPs during the delivery of SMILE.