Example results qualitative study.

Streptococcus suis (S. suis) infections in weaned pigs are common and responsible for a high consumption of antimicrobials, and their presence is assumed to be multi-factorial. A specific evidence-based veterinary guideline to support the control of S. suis in weaned pigs was developed for veterinary practitioners in the Netherlands in 2014. Adherence to the S. suis clinical practice guideline helps veterinary practitioners to prevent and control the disease in a systematical approach and thereby improve antimicrobial stewardship and contribute to the prevention of antimicrobial resistance in animals and humans. The impact of such a clinical practice guideline on (animal) disease management depends not only on its content, but also largely on the extent to which practitioners adhere to the clinical guideline in practice. When the S. suis guideline was published, no specific activities were undertaken to support veterinarians’ uptake and implementation, thereby contributing to suboptimal adherence in clinical practice. As the S. suis guideline was comprehensively written by veterinary experts following an evidence-based approach, our aim was not to judge the (scientific) quality of the guideline but to study the possibility to improve the currently low adherence of this guideline in veterinary practice. This paper describes the systematic development, using Implementation Mapping, of a theory-based intervention program to support swine veterinarians’ adherence to the S. suis guideline. The knowledge, skills, beliefs about capabilities, and beliefs about consequences domains are addressed in the program, which includes seven evidence-based methods (modelling, tailoring, feedback, discussion, persuasive communication, active learning, and self-monitoring) for use in program activities such as a peer-learning meeting and an e-learning module. The intervention program has been developed for practicing swine veterinarians, lasts eight months, and is evaluated through a stepped-wedge design. The Implementation Mapping approach ensured that all relevant adopters and implementers were involved, and that outcomes, determinants (influencing factors), and objectives were systematically discussed.猪链球菌（Streptococcus suis，S. suis）感染在断奶仔猪中极为常见，是造成抗菌药物大量消耗的重要诱因，且其发生被认为是多因素共同作用的结果。2014年，荷兰为兽医从业人员制定了专门针对断奶仔猪猪链球菌感染防控的循证兽医指南。遵守该猪链球菌临床实践指南，有助于兽医从业人员以系统化方式防控该病，进而强化抗菌药物管理，助力防控动物与人类的抗菌药物耐药性。此类临床实践指南对（动物）疾病管理的影响，不仅取决于其内容本身，还在很大程度上取决于从业人员在实际工作中对该指南的依从程度。该猪链球菌指南发布时，并未开展专门活动以支持兽医的采纳与实施，这直接导致了临床实践中依从性不佳的问题。鉴于该猪链球菌指南是由兽医专家以循证方式全面撰写而成，本研究的目的并非评判该指南的（科学）质量，而是探究提升当前兽医临床中该指南低依从率的可行路径。本文阐述了基于实施映射（Implementation Mapping）方法系统开发的、旨在支持生猪兽医遵守猪链球菌指南的理论驱动干预方案。该方案覆盖知识、技能、能力信念以及后果信念四大维度，包含7种循证干预方法，即示范教学、定制化干预、反馈、讨论、说服性沟通、主动学习与自我监控，可应用于同伴学习交流会、电子学习模块等活动场景中。本干预方案专为在职生猪兽医开发，实施周期为8个月，将通过阶梯楔形试验设计（stepped-wedge design）开展效果评估。实施映射方法确保了所有相关采用者与实施者均参与研究全过程，并对研究结局、决定因素（影响因素）与研究目标进行了系统化研讨。