{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:50:46Z","timestamp":1792155046111,"version":"4.4.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Dutch Organization"},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["10390162210014"],"award-info":[{"award-number":["10390162210014"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Female urinary incontinence (UI) affects one in three women and is frequently managed suboptimally. The app-based treatment URinControl demonstrated cost-effectiveness. However, implementation in Dutch primary care is limited. This study aimed to identify key barriers to implementation and develop strategies to support the uptake of URinControl in primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey among Dutch general practitioners (GPs), community pharmacists, and supporting personnel working in general practice or local pharmacies. Barriers were identified using the Consolidated Framework for Implementation Research (CFIR). Potential implementation strategies were selected using the CFIR\u2013Expert Recommendations for Implementing Change (ERIC) matching tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 174 healthcare professionals completed the questionnaire. Key barriers from both GP and pharmacy perspectives included doubts about the relative advantage of the app, limited knowledge of urinary incontinence and the app, organizational constraints, and limited digital skills among patients. In pharmacies, additional barriers included limited opportunity to discuss UI and concerns about financing. Based on these findings, five implementation strategies were developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Effective implementation of an evidence-based digital app for urinary incontinence in primary care requires improved awareness, knowledge, and support for healthcare professionals, as well as better structural integration of digital health tools into routine practice. Broader policy and societal shifts toward acceptance of eHealth are also needed. We also translated barriers into five tailored, theory-informed strategies addressing clinician education, patient engagement, workflow integration, financing, and collaboration between general practice and community pharmacy settings across the Netherlands in routine care implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/fampra\/cmag082","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:54:44Z","timestamp":1790855684000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation of an evidence-based app to improve healthcare for female urinary incontinence: identification of implementation strategies using the consolidated framework for implementation research-expert recommendations for implementation change matching tool"],"prefix":"10.1093","volume":"43","author":[{"given":"Anke C","family":"Lambooij","sequence":"first","affiliation":[{"name":"Department of Primary and Long-Term Care, Cure and Care in the Community Context (FOUR-C)- Research Program, University Medical Center Groningen, University of Groningen , PO box 196, 9700 AD Groningen ,","place":["The Netherlands"]},{"name":"Dutch Institute for Rational Use of Medicine , 3527GV Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk","family":"van der Worp","sequence":"additional","affiliation":[{"name":"Department of Primary and Long-Term Care, Cure and Care in the Community Context (FOUR-C)- Research Program, University Medical Center Groningen, University of Groningen , PO box 196, 9700 AD Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"van Noort","sequence":"additional","affiliation":[{"name":"Curavista. B.V. , 4941GV Raamdonksveer ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1086-8730","authenticated-orcid":false,"given":"Marco H","family":"Blanker","sequence":"additional","affiliation":[{"name":"Department of Primary and Long-Term Care, Cure and Care in the Community Context (FOUR-C)- Research Program, University Medical Center Groningen, University of Groningen , PO box 196, 9700 AD Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6582-1502","authenticated-orcid":false,"given":"Anne M M","family":"Loohuis","sequence":"additional","affiliation":[{"name":"Department of Primary and Long-Term Care, Cure and Care in the Community Context (FOUR-C)- Research Program, University Medical Center Groningen, University of Groningen , PO box 196, 9700 AD Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"2026101608090480800_cmag082-B1","volume-title":"Incontinence 7th Edition","author":"Cardozo","year":"2023"},{"key":"2026101608090480800_cmag082-B2","author":"Urge to Act"},{"key":"2026101608090480800_cmag082-B3","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.eururo.2025.05.025","article-title":"Prevalence, socioeconomic, and environmental costs of urinary incontinence in the European Union","volume":"88","author":"Bishop","year":"2025","journal-title":"Eur Urol"},{"key":"2026101608090480800_cmag082-B4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3109\/02813432.2011.628244","article-title":"Systematic screening for urinary incontinence in older women: who could benefit from it?","volume":"30","author":"Visser","year":"2012","journal-title":"Scand J Prim Health Care"},{"key":"2026101608090480800_cmag082-B5","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1080\/02813432.2022.2036497","article-title":"Primary care diagnostic and treatment pathways in Dutch women with urinary incontinence","volume":"40","author":"Schreuder","year":"2022","journal-title":"Scand J Prim Health Care"},{"key":"2026101608090480800_cmag082-B6","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1111\/1471-0528.17191","article-title":"Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months","volume":"129","author":"Loohuis","year":"2022","journal-title":"BJOG"},{"key":"2026101608090480800_cmag082-B7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1370\/afm.2585","article-title":"App-based treatment in primary care for urinary incontinence: a pragmatic, randomized controlled trial","volume":"19","author":"Loohuis","year":"2021","journal-title":"Ann Fam Med"},{"key":"2026101608090480800_cmag082-B8","doi-asserted-by":"publisher","first-page":"e040819","DOI":"10.1136\/bmjopen-2020-040819","article-title":"Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study","volume":"11","author":"Rygh","year":"2021","journal-title":"BMJ Open"},{"key":"2026101608090480800_cmag082-B9","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1002\/nau.23116","article-title":"Mobile app for treatment of stress urinary incontinence: a randomized controlled trial","volume":"36","author":"Asklund","year":"2017","journal-title":"Neurourol Urodyn"},{"key":"2026101608090480800_cmag082-B10","doi-asserted-by":"publisher","first-page":"e49868","DOI":"10.2196\/49868","article-title":"Barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. 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