Table 1 Facilitators and Barriers of the BETTER 2 program described using the CFIR

Intervention characteristic

Complexity

Amount of material was perceived as overwhelming and time consuming

Strong evidence for intervention (previous RCT)

Patients liked comprehensiveness (multifactorial approach as opposed to specific disease or organ)

Cost

Perception of intervention being too costly

Perception of intervention being cost effective (investing in prevention offsets acute care costs)

Outer setting

Perception of fit

Lack of remuneration

Lack of resources (particularly staff)

Physicians’ perception that PP’s prevention visit is a duplication of services

Perception by other stakeholders (including managers) that CDPS is a “hot topic”

Patients’ perception of visits as valuable, necessary and motivating

Characteristics of individuals

The PPs

Barrier did not emerge from data

Interest in prevention

Ability to support and motivate patients

Inner setting

Local champion

Lack of local champion or losing a local champion (e.g., physician left community)

Facilitator did not emerge from data

Working in a team versus working as a team

Not working as a team (e.g., team tensions, lack of relationship, competition, unclear roles)

Working as a team (e.g., trust; physicians appreciating PPs structuring CDPS)

Process

Planning and engaging

Not including collaborators enough in planning process

Starting collaborative conversations early

Collaboration and teamwork

Lack of awareness/misconception of BETTER approach

Availability of team members, frequent and open conversations