Comparative analysis: Contextual factors analysis of best performing SMIs

Main objectives:

  • To develop a contextual framework explaining how self-management interventions work in specific contexts and for specific patient groups
  • To compare and describe the most influencing contextual factors for successful implementation for the most effective self-management interventions (SMIs)
  • To make recommendations for how our findings can be incorporated in the COMPAR-EU platform
  • To harness international, national, and local knowledge and experience of SMIs


To better understand the effectiveness of SMIs, we search for qualitative studies of most effective SMIs identified in the network meta-analysis. Two specially trained researchers independently extract information of contextual factors using a structured form that documents methods, risk of bias, study population, intervention characteristics, contextual and cultural factors of the implementation and outcomes. A qualitative content analysis is applied to these studies and outcomes are synthesised for the four chronic conditions. A framework is developed for understanding the success of the selected SMIs. It shows context factors influencing at individual level, interaction level (patient with family/friends or patient with care professionals) and at the health care system level. A modified Delphi consultation with a panel of experts on self-management and/or implementation of health care interventions is performed to prioritise the influence and importance of the contextual factors on a European level. Finally, we prepare the integration of the results into the decision-making tools.

Leading partner: Netherlands Institute for Health Services Research (Nivel), The Netherlands

Other partners involved:

  • Fundaci√≥n Avedis Donabedian (FAD), Spain