{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:40:37Z","timestamp":1793130037295,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Birmingham Scholarship","award":["1986490"],"award-info":[{"award-number":["1986490"]}],"id":[{"id":"https:\/\/ror.org\/03angcq70","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,6,29]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to identify barriers to, and facilitators of, implementation of the Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme within existing cardiac rehabilitation services, and develop and refine the REACH-HF Service Delivery Guide (an implementation guide cocreated with healthcare professionals). REACH-HF is an effective and cost-effective 12-week home-based cardiac rehabilitation programme for patients with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants<\/jats:title>\n                    <jats:p>In 2019, four early adopter \u2018Beacon Sites\u2019 were set up to deliver REACH-HF to 200 patients. In 2020, 5 online REACH-HF training events were attended by 85 healthcare professionals from 45 National Health Service (NHS) teams across the UK and Ireland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Our mixed-methods study used in-depth semi-structured interviews and an online survey. Interviews were conducted with staff trained specifically for the Beacon Site project, identified by opportunity and snowball sampling. The online survey was later offered to subsequent NHS staff who took part in the online REACH-HF training. Normalisation Process Theory was used as a theoretical framework to guide data collection\/analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen healthcare professionals working at the Beacon Sites were interviewed and 17 survey responses were received (20% response rate). The identified barriers and enablers included, among many, a lack of resources\/commissioning, having interest in heart failure and working closely with the clinical heart failure team. Different implementation contexts (urban\/rural), timing (during the COVID-19 pandemic) and factors outside the healthcare team\/system (quality of the REACH-HF training) were observed to negatively or positively impact the implementation process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings are highly relevant to healthcare professionals involved in planning, delivering and commissioning of cardiac rehabilitation for patients with heart failure. The study\u2019s main output, a refined version of the REACH-HF Service Delivery Guide, can guide the implementation process (eg, designing new care pathways) and provide practical solutions to overcoming common implementation barriers (eg, through early identification of implementation champions).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-060221","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T12:22:40Z","timestamp":1657714960000},"page":"e060221","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Barriers and facilitators to implementation of a home-based cardiac rehabilitation programme for patients with heart failure in the NHS: a mixed-methods study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0942-3953","authenticated-orcid":false,"given":"Paulina","family":"Daw","sequence":"first","affiliation":[{"name":"School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2622-2501","authenticated-orcid":false,"given":"Grace E R","family":"Wood","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2257-6508","authenticated-orcid":false,"given":"Alexander","family":"Harrison","sequence":"additional","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1887-0237","authenticated-orcid":false,"given":"Patrick J","family":"Doherty","sequence":"additional","affiliation":[{"name":"Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8422-9512","authenticated-orcid":false,"given":"Jet J C S","family":"Veldhuijzen van Zanten","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-7544","authenticated-orcid":false,"given":"Hasnain M","family":"Dalal","sequence":"additional","affiliation":[{"name":"Royal Cornwall Hospital, University of Exeter Medical School, Truro, UK"},{"name":"Primary Care Research Group, University of Exeter Medical School, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-6011","authenticated-orcid":false,"given":"Rod S","family":"Taylor","sequence":"additional","affiliation":[{"name":"MRC\/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, University of Glasgow, Institute of Health and Well Being, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-2159","authenticated-orcid":false,"given":"Samantha B","family":"van Beurden","sequence":"additional","affiliation":[{"name":"College of Medicine and Health, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-3095","authenticated-orcid":false,"given":"Sinead T J","family":"McDonagh","sequence":"additional","affiliation":[{"name":"Primary Care Research Group, College of Medicine and Health, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4425-2691","authenticated-orcid":false,"given":"Colin J","family":"Greaves","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"2025120600400908000_12.7.e060221.1","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2016"},{"key":"2025120600400908000_12.7.e060221.2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1858"},{"key":"2025120600400908000_12.7.e060221.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/pgfar09010","article-title":"A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT","volume":"9","author":"Dalal","year":"2021","journal-title":"Programme Grants Appl Res"},{"key":"2025120600400908000_12.7.e060221.4","doi-asserted-by":"crossref","unstructured":"Long L , Mordi IR , Bridges C , et al . 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