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Table 2 Facilitating and impeding factors for each domain

From: The implementation of the coaching on lifestyle (CooL) intervention: lessons learnt

Domain

Facilitating factors

Impeding factors

Lifestyle coaches

- High level of work engagement

- Empathising with others

- Good contacts and getting along with the participants

- High involvement

- Great enthusiasm

- Openness

- Supporting instead of directing participants

- Patience

- Confidence in participants

- Knowledge and skills regarding systematic behaviour change

- Lack of entrepreneurship

- Lack of networking skills

- Not using the professional network for referring

Inner setting

- Having project groups

- Locations in the neighbourhood

- Support from the health care centre

- Cooperation between the LSCs

- No appropriate financial compensation for lifestyle coaches

- Too many unpaid administrative tasks for lifestyle coaches

Outer setting

 Participants

- Low drop-out rates

- Intrinsic motivation to change before the start

- High self-efficacy to change

- History of multiple failures in trying to lose weight

- Having other more important problems decreases motivation

- Financial problems

- Sense of not fitting in with the group

- Unsupportive parents regarding changing their child’s lifestyle

 Referrers

- Personal motivation of referrers

- Referrers’ knowledge of and experience with lifestyle coaching and the coaches

- Perceived lack of time or priority to be involved in the programme

- Some referrers knew too little about the programme

 Context

- Expected future coverage of CLIs by health insurance

- Collaborating with other partners and different disciplines

- Increased familiarity with the lifestyle coaches and their role

- Health care professional’s unawareness about their role in lifestyle change

Implementation process

 Planning

- Involvement of stakeholders in project groups

- Too little time for implementation to create support among the referrers

 Engaging

- Creating support

- Kick-off meetings

- Protocols for lifestyle coaches and referrers

- Not having the logistics organised at the start of the implementation

 Executing

- Effective communication and collaboration between lifestyle coaches and referrers

- Attending more meetings to inform the referrers

- Articles in local newspapers

- Time investment for lifestyle coaches, stakeholders and participants

- Too few personal contacts with referrers

- Lack of clear communication materials

 Reflecting and evaluating

- Most participants were satisfied

- Ensuring well-organised preconditions

- Having suitable manuals for new lifestyle coaches

- Too heterogeneous groups and large differences between participants

- Too much time between contact moments, and between registration and start of the group

- Too few individual coaching sessions (for children)

- No ambassador in every region

 CooL intervention

- Frequent contacts over a period of six months

- Optimised combination of individual and group sessions

- Not only focusing on nutrition, but multiple themes including stress and sleep

- Learning from peers

- Whole family takes part in the children’s programme

- Home visits for children

- Participant-centred approach

- Positive approach aimed at increasing autonomous motivation

- Knowledge transfer and practical implications for daily life

- Approach tailored to the participants’ needs

- Flexibility in design and content

- Easily accessible for participants

- No charge for participants

- Inadequate time slots for group sessions

- Strict inclusion criteria

- Participant materials with too much text

- Materials not suitable for non-Dutch speaking persons