Implementation of blended and combined exercise and nutrition programs for older adults

Purpose: Interprofessional collaboration and adaptation of e-health are necessary to implement innovative exercise and nutrition interventions in health practice. The aims of this qualitative study were 1) determine the relevant factors related to successful interprofessional collaboration, and 2) determine the relevant factors for implementation and susceptibility of our blended interventions in older adults, by allied health professionals in the Amsterdam metropolitan region.<br/>Methods: This explorative qualitative study was the next step in implementation, subsequent to the VITAMIN RCT. In total 45 physiotherapy and 27 dietician practices were selected for recruitment. We combined fourteen semistructured<br/>interviews with dieticians with two focus-groups of mixed exercise- and physiotherapists. After each focus-group and interview the two researchers evaluated and discussed the statements, factors and common believes in relation to the research questions. Transcripts were analyzed with MAXQDA software, and open, axial and selective coding was adapted by two independent researchers. A third researcher was available if consensus could not be reached.<br/>Results: In current practice interprofessional collaboration is not common, mainly due to lacking knowledge about the other profession. Location is a facilitator, as well is previous experience. External factors as higher financial<br/>compensation to implement interprofessional work meetings were defined as possible facilitator to collaboration. The professionals defined a shared electronic patient database as necessity to interprofessional collaboration,<br/>especially due to the privacy regulations. Main encouraging factors related to blended interventions were timesaving consults, ability to reach immobile older adults, and cost saving healthcare. Main barrier was lacking e-health literacy<br/>of older adults.<br/>Conclusions: This study shows that the exercise and nutrition professionals have a positive attitude towards future implementation of these types of blended and combined interventions for older adults. Furthermore, interprofessional collaboration is a point of attention in our regional allied healthcare system. Several external factors related to implementation, like financial compensation, make the adaptation of combined interventions with e-health for older adults challenging.