Darcy Ummels

Using an activity tracker in daily clinical practice | 131 6 discussed. Unfortunately, due to the closing of the specialized mental healthcare center during the COVID ‐ 19 pandemic, it was not possible to add a fourth iteration. Comparison to other studies Our findings are comparable with another participatory action study that focused on the implementation of eHealth in specialist nursing teams who case ‐ managed patients with chronic obstructive pulmonary disease and chronic heart failure and who were using telehealth to monitor patients’ vital signs and symptoms. 65 They formulated seven main areas of work in their implementation plan: (1) establishing a telehealth pathway, (2) improving patient assessment and review, (3) improving service delivery, (4) improving data sharing and access, (5) raising awareness of telehealth, (6) improving the evaluation of telehealth, and (7) securing financial investment for telehealth. Some areas are comparable to this study, and other areas were not within the scope of this study, such as securing financial investments. However, these topics are also important and could be further assessed in further research. An important difference between the study of Taylor et al. and our study is that healthcare professionals already had experience with the use of telehealth in their daily clinical practice. 66 Other studies showed that if healthcare professionals are already experienced in using eHealth, they report fewer implementation barriers and experience more advantages (e.g., more positive attitude towards eHealth). 66,67 Many of the facilitators and barriers for implementation are equal for eHealth measurement tools and other measurement tools, such as questionnaires. 34,36 ‐ 39,68 The review of Foster et al. emphasized the importance of involving the target population and allowing them to learn and reflect on the use of the measurement tool and guide them through the whole implementation process. 68 In our study, we started with a draft manual, based on literature, on how to use activity trackers/eHealth in daily clinical practice, which was redeveloped by experience ‐ based testing by the therapists, and guidance by the research team was given during the reflection sessions. The design and approach of this study could be used as an example for other implementation studies. The topics of security and compatibility with existing systems were not within the scope of this study, and the topics within our coding framework sharing data and privacy (e.g., safely sharing data and warrant of privacy) were not discussed by the therapists in this study but are also relevant factors for implementation. 34,36 ‐ 39 Methodological quality This study had some limitations. First, there was a limited number of therapists and patients included, and the therapists had relatively short work experience. More