Table 1 Description case example SMILe projecta ([32,33,34]; Valenta S, Ribaut J, Leppla L, Mielke J, Teynor A, Koehly K, Gerull S, Grossmann F, Witzig-Brändli V, De Geest S, for the SMILe study team: Context-specific adaptation of an eHealth-facilitated, integrated care model and tailoring its implementation strategies – a mixed-methods study as a part of the SMILe implementation science project, Under review)
Background | |
Follow-up care of allogeneic hematopoietic stem cell transplanted (alloSCT) patients is challenged due to growing numbers of alloSCT transplant survivors who have complex care needs. Current follow-up models are biomedically driven rather than focusing on behavioral, psychosocial, and self-management support elements. | |
Aim SMILe project | |
SMILe is an implementation science project to develop/adapt, test, and implement an eHealth-facilitated integrated care model (ICM) in allogeneic stem cell transplantation (SMILe-ICM). | |
Methods | |
SMILe is a multi-site project consisting of phase A (contextual and technology acceptance analysis and development of intervention and implementation strategies) and phase B (implementation and testing of the intervention). Phase A has been completed in two transplant centers in Germany (intervention development) and Switzerland (intervention adaptation), and further centers in Belgium and Switzerland will follow. The SMILe-ICM is currently being implemented and tested (phase B) using a hybrid type 1 effectiveness-implementation design at two study sites in Germany and Switzerland, and first results are expected in 2022 and 2023. | |
Intervention | |
The SMILe-ICM is based on the eHealth enhanced Chronic Care Model and targets patients, healthcare providers, and the system [35]. It includes a human and an eHealth component. The human component is an advanced practice nurse (SMILe Care Coordinator), who provides self-management support and health behavior promotion via face-to-face visits [33, 36]. The SMILe App (eHealth component) allows the patient to enter values on a daily basis and send them to the transplant center. Via SMILeCare, the Smile Care Coordinator can overview incoming data regularly, allowing early detection of health deterioration. Face-to-face visits can be adapted according to patients’ needs. | |
Contextual analysis — aims | |
The aims of the contextual analysis were as follows: (1) to identify the target organization’s structural characteristics and practice patterns in view of chronic illness management, (2) to assess how self-management and behavioral support are currently supported, (3) to assess the technology openness of clinicians and alloSCT patients regarding eHealth use along the eCCM dimensions, and (4) to explore facilitators and barriers to SMILe-ICM implementation (only assessed in second study site to date). |