Intervention mapping for the development of a strategy to implement the insurance medicine guidelines for depression

Abstract

BackgroundThis article describes the development of a strategy to implement the insurance medicine guidelines for depression. Use of the guidelines is intended to result in more transparent and uniform assessment of claimants with depressive symptoms.MethodsThe implementation strategy was developed using the Intervention Mapping (IM) method for alignment with insurance-medical practice. The ASE behavioural explanation model (Attitude, Social Influence and Self-Efficacy) was used as theoretical basis for the development work. A literature study of implementation strategies and interviews with insurance physicians were performed to develop instruments for use with the guideline. These instruments were designed to match the needs and the working circumstances of insurance physicians. Performance indicators to measure the quality of the assessment and the adherence to the guidelines were defined with input from insurance physicians.ResultsThis study resulted in the development of a training course to teach insurance physicians how to apply the guidelines for depression, using the aforementioned instruments. The efficacy of this training course will be evaluated in a Randomized Controlled Trial.ConclusionsThe use of IM made it possible to develop guideline support instruments tailored to insurance medical practice.

Methods to Improve the Selection and Tailoring of Implementation Strategies

“…78 While intervention mapping has been proposed as a method for tailoring implementation strategies to identified barriers, 22,39 it has not been widely used, with a few notable exceptions. 79,80 …”

“…80 The purpose of the guidelines was to ensure that assessments of depression symptoms by physicians were transparent and uniform. Zwerver and colleagues 80 provide a detailed account of the intervention mapping process, which resulted in the development of a multifaceted implementation strategy.…”

“…80 The purpose of the guidelines was to ensure that assessments of depression symptoms by physicians were transparent and uniform. Zwerver and colleagues 80 provide a detailed account of the intervention mapping process, which resulted in the development of a multifaceted implementation strategy. Figure 4 provides a succinct summary of the associated determinants (barriers and facilitators), learning objectives, theory-based methods, and discrete implementation strategies that were generated.…”

Stochastic modelling of infectious diseases for heterogeneous populations

“…For example, Birrell et al [40] provided an age structure-based compartmental model with a Bayesian synthesis of multiple evidence sources to reveal substantial changes in contact patterns throughout the epidemic. Besides of the compartmental models, other mathematical models are also used to describe the transmission dynamics [3, 42–47]. The chain binomial model was used to calculate the household secondary attack rates to measure the transmissibility of the 2009 H1N1 influenza pandemic by Lessler et al [44] and Klick et al [45].…”

“…Ferguson et al [3] and Cauchemez et al [42, 43] incorporated other factors, such as household risk, within-school risk, and community risk, in the study of infection spread and found out that younger age groups under 19 years old were more susceptible than older age groups. Jin et al [47] formulated an epidemic model of influenza A based on networks and calculated the basic reproduction number and studied the effects of various immunization schemes. However, this work required that the individual contact pattern be provided.…”