Characteristics of participants.

Purpose A lifestyle front office (LFO) in the hospital is a not yet existing, novel concept that can refer patients under treatment in the hospital to community-based lifestyle interventions (CBLI). The aim of this study was to identify implementation barriers and facilitators regarding the implementation of an LFO in the hospital from the perspective of CBLI-professionals and to develop evidence-based implementation strategies to reduce these identified barriers. Methods We conducted semi-structured interviews until data saturation, with 23 lifestyle professionals working in the community. A semi-structured topic guide was used, inquiring about (1) community-based lifestyle interventions; (2) their views about referral from the LFO; and (3) their preferences, needs and recommendations for collaboration with the LFO in the hospital. The online interviews lasted on average 46 minutes, were audio-recorded and transcribed verbatim. A thematic content analysis was conducted. Found barriers and facilitators regarding the LFO where mapped using the consolidated framework for implementation research (CFIR) whereafter evidence based strategies were developed using the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC). Results Barriers and facilitators were divided into two main themes: 1) barriers and facilitators related to the referral from LFO to CBLI (i.e. financial, cultural, geographical, quality) and 2) barriers and facilitators related to the collaboration between LFO and CBLI (i.e. referral, communication platform and partnership). Thirty-seven implementation strategies concerning 15 barriers were developed and clustered into six overarching strategies: identify referral options, determine qualifications lifestyle professionals, develop support tools, build networks, facilitate learning collaboratives, and optimize workflow. Conclusions In this study, barriers and facilitators for the development of the LFO were found and matching implementation strategies were developed. Practical improvements, like identifying specific referral options or develop support tools, can be implemented immediately. The implementation of other strategies, like connecting care pathways in basic services, primary, secondary and tertiary care, will take more time and effort to come to full potential. Future research should evaluate all implemented strategies.研究目的 医院生活方式前台（lifestyle front office, LFO）是一项尚未落地的全新概念，可将医院内接受诊疗的患者转诊至社区生活方式干预（community-based lifestyle interventions, CBLI）项目。本研究旨在从社区生活方式干预从业者的视角，识别医院推行LFO过程中的实施障碍与促进因素，并开发循证实施策略以缓解上述已识别的障碍。 研究方法 本研究采用半结构化访谈法开展数据收集，直至达到数据饱和，共访谈了23名供职于社区的生活方式从业者。研究使用半结构化访谈提纲，调研内容涵盖：（1）社区生活方式干预项目；（2）从业者对于LFO转诊模式的看法；（3）从业者对于与医院LFO开展合作的偏好、需求与建议。线上访谈平均时长为46分钟，全程录音并进行逐字转录。本研究采用主题内容分析法开展数据分析，依托综合实施研究框架（consolidated framework for implementation research, CFIR）对LFO相关的实施障碍与促进因素进行归类梳理，随后借助CFIR专家推荐的变革实施策略匹配工具V1.0版（CFIR-ERIC）开发了循证实施策略。 研究结果 本研究将识别出的实施障碍与促进因素划分为两大核心主题：1）LFO向CBLI转诊相关的障碍与促进因素（涵盖财务、文化、地理、质量四大维度）；2）LFO与CBLI合作相关的障碍与促进因素（涵盖转诊机制、沟通平台与伙伴关系三大维度）。最终针对15项实施障碍开发了37项实施策略，并将其归纳为六大总体策略：明确转诊路径、明确生活方式从业者资质要求、开发配套支持工具、搭建合作网络、推动协作式学习以及优化工作流程。 研究结论 本研究明确了LFO推行过程中的实施障碍与促进因素，并开发了匹配的实施策略。诸如明确专属转诊路径、开发配套支持工具等实操优化举措，可立即落地推行；而诸如打通基础医疗、一级、二级与三级医疗照护路径等其他策略，则需投入更多时间与精力方能充分释放其效用。未来研究需对所有落地实施的策略开展效果评估。