{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T17:04:41Z","timestamp":1793898281428,"version":"4.8.0"},"reference-count":47,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Care for mild to moderate chronic kidney disease (CKD) entails self-management from patients and clinical support from primary care and nephrology. To address the gap in self-management resources, My Kidneys My Health was codeveloped to support patients with CKD. Health care providers play a critical role in the implementation of patient resources; however, there is a gap in understanding providers\u2019 perspectives in this role.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study develops and evaluates strategies to implement My Kidneys My Health into routine primary care and general nephrology clinical care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Health care providers working in Alberta, Canada, who support patients with CKD were invited to participate in our multistep study, guided by the Quality Implementation Framework. In step 1, we followed qualitative descriptive methodology to identify barriers and enablers to implementation using a directed content analysis and a deductive coding approach. Participants were invited to complete semistructured interviews from October 2021 to May 2022. In step 2, we identified, prioritized, codeveloped, and launched implementation strategies based on step 1 results using behavior change theory. Participants were invited to use the materials during the implementation period (May to October 2022). Website engagement was tracked through Google Analytics and document distribution tracking. In step 3, we conducted follow-up interviews with participants (October to December 2022) to evaluate implementation based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, following the same qualitative approach as step 1. Effectiveness was out of the scope of this study.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 16 health care providers participated in step 1 qualitative interviews (8 from nephrology clinics and 5 from primary care or nonambulatory care). Participants shared an individual-level readiness and interest in sharing My Kidneys My Health with their patients. The key barriers to implementation included awareness, memory, time, motivation, and innovation accessibility. Implementation strategies were co-designed and implemented by step 1 participants (ie, educational sessions and materials, reminders, and implementation coaching). Notably, 9 health care providers participated in step 3 qualitative interviews. Participants shared their approach to tailoring implementation based on their patients and integrating the resource into their current practices. The resources developed were highly used by participants, with positive feedback on their usability and accessibility. Participants expressed motivation to continue sharing My Kidneys My Health\n ;<\/jats:italic>\n however, awareness and accessibility require further adaptations that can improve sustainability of implementation. Our rigorous approach allowed us to address behavior change and sustainability of implementation of My Kidneys My Health, as well as identify appropriate and tailored implementation strategies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n There is a readiness to implement self-management supports for patients with early-stage CKD. A theory-informed approach and strategic implementation strategies can support sustainability.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/71832","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T14:05:08Z","timestamp":1751033108000},"page":"e71832-e71832","source":"Crossref","is-referenced-by-count":5,"title":["Implementation and Evaluation of a Patient-Focused eHealth Intervention, My Kidneys My Health, in Primary Care and General Nephrology Clinics: Multimethods Study"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8310-0052","authenticated-orcid":false,"given":"Sabrina","family":"Jassemi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6745-3317","authenticated-orcid":false,"given":"Dwight","family":"Sparkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7100-3207","authenticated-orcid":false,"given":"Maria","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-1605","authenticated-orcid":false,"given":"Lori","family":"Harwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6905-5937","authenticated-orcid":false,"given":"Aminu K","family":"Bello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5421-4205","authenticated-orcid":false,"given":"Heather","family":"Beanlands","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5434-2917","authenticated-orcid":false,"given":"Meghan","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6024-7828","authenticated-orcid":false,"given":"Kerry","family":"McBrien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2517-2912","authenticated-orcid":false,"given":"Sarah","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6106-832X","authenticated-orcid":false,"given":"Sharon","family":"Straus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6818-4385","authenticated-orcid":false,"given":"Brenda","family":"Hemmelgarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8484-8361","authenticated-orcid":false,"given":"Maoliosa","family":"Donald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1053\/j.ackd.2007.10.011","article-title":"Disease management in chronic kidney disease","volume":"15","author":"Rastogi","journal-title":"Adv Chronic Kidney Dis"},{"issue":"10","key":"R2","first-page":"728","volume":"64","author":"Grill","journal-title":"Can Fam Physician"},{"key":"R3","unstructured":"Kidney health strategic clinical network. Alberta Health Services. 2016. URL: https:\/\/www.albertahealthservices.ca\/assets\/about\/scn\/ahs-scn-kh-transformational-road-map.pdf [Accessed 23-07-2025]"},{"issue":"2","key":"R4","first-page":"147","volume":"35","author":"Costantini","journal-title":"Nephrol Nurs J"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"565","DOI":"10.2215\/CJN.12391211","article-title":"A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease","volume":"7","author":"Manns","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1016\/j.pop.2014.08.004","article-title":"The primary care physician\/nephrologist partnership in treating chronic kidney disease","volume":"41","author":"Baldwin","journal-title":"Prim Care"},{"issue":"2","key":"R7","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1111\/sdi.12080","article-title":"Approaches to self-management in chronic illness","volume":"26","author":"Novak","journal-title":"Semin Dial"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1093\/ndt\/gfw065","article-title":"Determining the research priorities for patients with chronic kidney disease not on dialysis","volume":"32","author":"Hemmelgarn","journal-title":"Nephrol Dial Transplant"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019814","article-title":"Self-management interventions for adults with chronic kidney disease: a scoping review","volume":"8","author":"Donald","journal-title":"BMJ Open"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1177\/2054358118775098","article-title":"Overview of self-management resources used by canadian chronic kidney disease clinics: a national survey","volume":"5","author":"Donald","journal-title":"Can J Kidney Health Dis"},{"issue":"4","key":"R11","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1053\/j.ajkd.2019.02.006","article-title":"Identifying needs for self-management interventions for adults with CKD and their caregivers: a qualitative study","volume":"74","author":"Donald","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"R12","doi-asserted-by":"publisher","first-page":"E713","DOI":"10.9778\/cmajo.20190081","article-title":"Preferences for a self-management e-health tool for patients with chronic kidney disease: results of a patient-oriented consensus workshop","volume":"7","author":"Donald","journal-title":"CMAJ Open"},{"issue":"2","key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/22220","article-title":"A web-based self-management support prototype for adults with chronic kidney disease (my kidneys my health): co-design and usability testing","volume":"5","author":"Donald","journal-title":"JMIR Form Res"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-018-0830-8","article-title":"Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study","volume":"19","author":"Bonner","journal-title":"BMC Nephrol"},{"issue":"11","key":"R15","doi-asserted-by":"publisher","DOI":"10.2196\/12384","article-title":"Electronic health self-management interventions for patients with chronic kidney disease: systematic review of quantitative and qualitative evidence","volume":"21","author":"Shen","journal-title":"J Med Internet Res"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1177\/2054358119863091","article-title":"Content and quality of websites for patients with chronic kidney disease: an environmental scan","volume":"6","author":"Smekal","journal-title":"Can J Kidney Health Dis"},{"key":"R17","unstructured":"Living well with chronic kidney disease (CKD). My Kidneys My Health. 2019. URL: https:\/\/mykidneysmyhealth.com [Accessed 23-07-2025]"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1177\/2054358117749530","article-title":"Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD): Form and Function","volume":"5","author":"Levin","journal-title":"Can J Kidney Health Dis"},{"key":"R19","unstructured":"Graham ID Tetroe JM . R-M J , editor. The Knowledge to Action Framework. Wiley-Blackwell; 2010:207-222."},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-016-0389-3","article-title":"Patient-mediated knowledge translation (PKT) interventions for clinical encounters: a systematic review","volume":"11","author":"Gagliardi","journal-title":"Implementation Sci"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.03.506","article-title":"POS-479 Acceptability and feasibility of a web-based self-management support intervention for adults with chronic kidney disease: a mixed-methods study","volume":"6","author":"Donald","journal-title":"Kidney Int Rep"},{"issue":"8","key":"R22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220116","article-title":"Helping patients help themselves: a systematic review of self-management support strategies in primary health care practice","volume":"14","author":"Dineen-Griffin","journal-title":"PLoS ONE"},{"issue":"3-4","key":"R23","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1007\/s10464-012-9522-x","article-title":"The quality implementation framework: a synthesis of critical steps in the implementation process","volume":"50","author":"Meyers","journal-title":"Am J Community Psychol"},{"issue":"6","key":"R24","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","journal-title":"Int J Qual Health Care"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1177\/2054358119848126","article-title":"Understanding adults with chronic kidney disease and their caregivers\u2019 self-management experiences: a qualitative study using the Theoretical Domains Framework","volume":"6","author":"Baay","journal-title":"Can J Kidney Health Dis"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1177\/20543581211063981","article-title":"Development and preliminary psychometric testing of an adult Chronic Kidney Disease Self-Management (CKD-SM) questionnaire","volume":"8","author":"Smekal","journal-title":"Can J Kidney Health Dis"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s43477-022-00038-3","article-title":"A research protocol for implementation and evaluation of a patient-focused eHealth intervention for chronic kidney disease","volume":"2","author":"Donald","journal-title":"Glob Implement Res Appl"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","DOI":"10.2196\/21698","article-title":"Health care professionals\u2019 experience of a digital tool for patient exchange, anamnesis, and triage in primary care: qualitative study","volume":"7","author":"Eldh","journal-title":"JMIR Hum Factors"},{"issue":"7","key":"R29","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1007\/s11606-019-04975-y","article-title":"Primary care physicians\u2019 perceived barriers to nephrology referral and co-management of patients with CKD: a qualitative study","volume":"34","author":"Greer","journal-title":"J Gen Intern Med"},{"issue":"3-4","key":"R30","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s10464-012-9509-7","article-title":"Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance\/quality improvement","volume":"50","author":"Wandersman","journal-title":"Am J Community Psychol"},{"issue":"9","key":"R31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014417","article-title":"What makes a sustainability tool valuable, practical and useful in real-world healthcare practice? A mixed-methods study on the development of the Long Term Success Tool in Northwest London","volume":"7","author":"Lennox","journal-title":"BMJ Open"},{"issue":"9","key":"R32","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","journal-title":"Qual Health Res"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","journal-title":"Implement Sci"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","journal-title":"Implementation Sci"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01181-5","article-title":"Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum","volume":"17","author":"Damschroder","journal-title":"Implement Sci"},{"key":"R36","unstructured":"Michie S Atkins L West R . The Behaviour Change Wheel: A Guide to Designing Interventions. 1st ed. Siverback Publishing; 2014."},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: the kappa statistic","volume":"22","author":"McHugh","journal-title":"Biochem Med (Zagreb)"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0","article-title":"The updated Consolidated Framework for Implementation Research based on user feedback","volume":"17","author":"Damschroder","journal-title":"Implement Sci"},{"issue":"5","key":"R39","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1093\/tbm\/ibaa050","article-title":"Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus","volume":"11","author":"Johnston","journal-title":"Transl Behav Med"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0951-x","article-title":"Action, actor, context, target, time (AACTT): a framework for specifying behaviour","volume":"14","author":"Presseau","journal-title":"Implement Sci"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00064","article-title":"RE-AIM planning and evaluation framework: adapting to new science and practice with a 20-year review","volume":"7","author":"Glasgow","journal-title":"Front Public Health"},{"issue":"9","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/14255","article-title":"Implementation strategies to enhance the implementation of eHealth programs for patients with chronic illnesses: realist systematic review","volume":"21","author":"Varsi","journal-title":"J Med Internet Res"},{"issue":"8","key":"R43","doi-asserted-by":"publisher","DOI":"10.2196\/38424","article-title":"Evaluation of a digital self-management platform for patients with chronic illness in primary care: qualitative study of stakeholders\u2019 perspectives","volume":"6","author":"van de Vijver","journal-title":"JMIR Form Res"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-024-02317-4","article-title":"Self-management support (SMS) in primary care practice: a qualitative focus group study of care professionals\u2019 experiences","volume":"25","author":"Timmermans","journal-title":"BMC Prim Care"},{"issue":"4","key":"R45","doi-asserted-by":"publisher","DOI":"10.2196\/15038","article-title":"Using patient portals to improve patient outcomes: systematic review","volume":"6","author":"Han","journal-title":"JMIR Hum Factors"},{"issue":"3","key":"R46","doi-asserted-by":"publisher","DOI":"10.2196\/12490","article-title":"The rise of the empowered physician in the digital health era: viewpoint","volume":"21","author":"Mesko","journal-title":"J Med Internet Res"},{"issue":"9","key":"R47","doi-asserted-by":"publisher","DOI":"10.2196\/26189","article-title":"The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: updated systematic literature review","volume":"23","author":"Carini","journal-title":"J Med Internet Res"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e71832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:01:40Z","timestamp":1782842500000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e71832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":47,"URL":"https:\/\/doi.org\/10.2196\/71832","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]},"article-number":"v27i1e71832"}}