Factors influencing REducing Delay through edUcation on eXacerbations (REDUX) implementation: A stakeholder analysis

Abstract

REducing Delay through edUcation on eXacerbations (REDUX) shows promise in reducing exacerbation recognition and action delays for chronic lung diseases in the Netherlands. However, factors influencing its successful implementation in China remain unclear. To identify the perceived factors influencing nurse-led self-management implementation of REDUX in China, stakeholder analysis using qualitative and quantitative approaches was conducted. A qualitative approach assessed support for REDUX, perceived influencing factors, and preferred intervention delivery mode among patients, healthcare professionals, and policymakers. A quantitative approach identified necessary conditions for developing and implementing a digital-version intervention, involving app developers and cyber-security officers. The study followed COREQ and stakeholder analysis guidelines. Thirty-five patients, healthcare professionals, and policymakers highly supported REDUX. Perceived influencing factors included facilitators (e.g., easy-to-use design, perceived benefits) and barriers (e.g., patients’ affordability, lack of policy support). Preferred intervention delivery modes varied among stakeholders. Eighty-seven app developers and cyber-security officers completed quantitative surveys. The quantitative data showed that the work process of developing the health apps and protecting the users’ security and privacy mostly aligned with the related international guideline recommendations. The study identified key interdependent factors that were perceived as crucial for REDUX implementation success. Healthcare policies should prioritize self-management intervention, and minor action plan adjustments are needed.