Successful Implementation Research Articles

Intravenous push lacosamide: Successful implementation and patient outcomes across a health system.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Intravenous administration of the antiseizure medication lacosamide can be delayed given operational challenges related to short beyond-use-dating and controlled substance requirements. The purpose of this study was to describe the steps required to successfully transition from intravenous piggyback administration to intravenous push administration and demonstrate that workflow changes improved time to administration without compromising patient safety. This multicenter study had 2 components; the first portion was a prospective description of the implementation and operationalization process, while the second was a retrospective cohort analysis comparing patients who received intravenous piggyback and intravenous push lacosamide. After the transition, the default administration route for adult patients for lacosamide doses of 400mg or less was intravenous push. While the primary objective was to describe the implementation process, secondary objectives included comparison of time to administration and safety, using a composite and incidence of PR prolongation. Success in implementation and operationalization across a large health system was achieved by following a 6-month timeline. A total of 102 patients were included in the cohort study, with 869 individual administrations analyzed (519 intravenous piggyback and 350 intravenous push). Time from verification to administration was significantly decreased when comparing intravenous piggyback (median, 159 minutes) to intravenous push (median, 88 minutes) administrations (P = 0.008). No significant difference was found in the safety composite or PR prolongation. Transitioning intravenous lacosamide administration from piggyback to push administration is feasible and decreases time from verification to administration without increased incidence of adverse effects.

Fiscal Policy and Economic Stability: A Comprehensive Analysis

This piece outlines fiscal policy and how it helps in stabilizing the economy. It starts with explaining fiscal policy and emphasizing its role as an effective tool for economic management. Tax policies, government spending, and budget deficits/surpluses which make up fiscal policy are discussed in details. The article continues by discussing the influence of fiscal policy on the economy's stability, considering its ability to boost growth, curb inflation, and reduce unemployment. While the management of fiscal policy comprises of the challenges such as political concerns and coordination with monetary policy, is also examined. Case studies and examples demonstrate success and failure of those fiscal policy implementation, which have become an invaluable lesson for policy makers. The article concludes with a look into the future trends and some suggestions on sustainable fiscal policy procedures.

Building on Strong Foundations: Deploying Enhanced Replicating Effective Programs for evidence-based prevention curriculum adaptation.

Schools frequently adopt new interventions for each new public health issue, but this is both time- and resource-intensive. Adversity exposure is an example of a pervasive public health issue that emerged during Coronavirus Disease 2019 (COVID-19) with notable consequences, including an elevated risk of developing substance use disorders and mental illnesses. Adapting existing, universal, evidence-based interventions, such as the Michigan Model for HealthTM (MMH), by incorporating trauma-sensitive content is a promising approach to meet this need. We examined critical steps in promoting MMH adaptability as part of the Enhanced REP (Replicating Effective Programs) implementation strategy during the COVID-19 pandemic. We share usability testing from the 2020 to 2021 school year and describe how we apply the results to inform the group randomized trial pilot study. We applied key steps from implementation adaptation frameworks to integrate trauma-sensitive content as COVID-19 unfolded, documenting the process through field notes. We conducted initial usability testing with two teachers via interviews and used a rapid qualitative analysis approach. We conducted member checking by sharing the information with two health coordinators to validate results and inform additional curriculum refinement. We developed an adapted MMH curriculum to include trauma-sensitive content, with adaptations primarily centered on adding content, tailoring content, substituting content, and repeating/reinforcing elements across units. We designed adaptations to retain the core functional elements of MMH. Building foundational relationships and infrastructure supports opportunities to user-test intervention materials for Enhanced REP that enhance utility and relevance for populations that would most benefit. Enhanced REP is a promising strategy to use an existing evidence-based intervention to meet better the needs of youth exposed to adversity. Building on the foundations of existing evidence-based interventions, is vital to implementation success and achieving desired public health outcomes.

Measuring total productive maintenance success: a new industrial evaluation using fuzzy SERVQUAL

ABSTRACT In today’s competitive business landscape, maintaining market position and customer satisfaction relies on high-quality equipment maintenance. Total Productive Maintenance (TPM) is a popular method for optimizing internal efficiency. However, despite its popularity, companies still face challenges in implementing TPM. This study proposes a comprehensive evaluation model combining SERVQUAL and fuzzy set theory (Fuzzy SERVQUAL) to assess TPM implementation and identify obstacles for focused strategies. The results demonstrated that the level of implementation within the Moroccan industrial sector ranges from 3 to 4, as per the Classic SERVQUAL, showing a minimum level between 2 and 3 and a maximum level between 4 and 5 based on the nuanced analysis of Fuzzy SERVQUAL. The success of TPM implementation in the industrial sector is largely attributed to the human element, which includes prioritizing employee attention, enhancing skills, and which involves prioritizing employee attention, skill enhancement, and active involvement in decision-making processes.

Patient self-reported pain and nausea via smartphone following day care surgery, first year results: An observational cohort study.

Contact with the hospital is usually limited for patients after day care surgery. Dedicated smartphone applications can improve communication and possibly enhance outcomes. The objective of this retrospective study was to evaluate patients' self-reported pain and nausea and assess the success of routine implementation of a smartphone application for outcome reporting. During preoperative assessment, patients were instructed to download and activate the smartphone application to report pain, nausea and to be in contact with the hospital after discharge. Main outcome was the number of patients actively using the smartphone application and the incidence of pain and nausea on postoperative day 1 to 7. In total, 4952 patients were included in the study. A total of 592 (12%) participants downloaded the application, of whom 351 (7%) were active users. A total of 4360 (88%) participants refrained from downloading the application. 56% (2,769) were female, the median age was 46 (18-92), and 4286 (87%) were classified as 1 or 2 American Society of Anesthesiologists Physical Status (ASA). Postoperative pain was experienced by 174 (76%) of 229 active users on postoperative day (POD) 1 and decreased to 44 (44%) of 100 active users on POD7. Postoperative nausea was experienced by 63 (28%) of 229 active users on POD1 and decreased to 12 (12%) of 100 active users on POD7. Female sex (p .000), socioeconomic status (p .001), and surgical severity (p .001) showed statistically significant differences between active users, non-active users, and non-downloaders. Most patients active with the application experienced pain and nausea on the first and second day after discharge. Only a minority of the patients used the application. Those who used it were satisfied with the possibilities offered to them. Future research should focus on increasing the uptake and effect of this application on the quality of recovery.

Building information modeling (BIM) implementation and construction project success in Malaysian construction industry: mediating role of project control

PurposeThe primary objective of this study is to analyze the correlation between the application of building information modeling (BIM), the construction project success (CPS) and project control. Additionally, this research aims to explore the potential mediating effect of project control on the link between BIM and construction project success in the Malaysian construction industry.Design/methodology/approachThe present study employs a quantitative research methodology and adheres to a positivist research philosophy in order to examine the influence of BIM implementation on the CPS and project control within the Malaysian construction sector. The data were collected by structured questionnaire survey from 200 respondents using a purposive sampling strategy, and the results were analyzed by using partial least square (PLS)-structural equation modeling (SEM). The study's findings are all the more noteworthy since, despite the small sample size, 218 persons genuinely participated thanks to the purposive sampling approach.FindingsThe findings of this study indicate that there are notable and positive associations between various variables related to the implementation of BIM. These variables include accurate quantities and estimations, risk management, facility management integration, optimized resource allocation and real-time monitoring. Furthermore, these relationships are observed to have a significant impact on both CPS and project control. The study revealed that project control serves as a mediator in the relationship between the deployment of BIM and the CPS in the Malaysian construction sector, with the exception of its influence on risk management.Originality/valueThe originality of this research consists in examining the mediating function of project control in the relationship between BIM implementation and CPS. This study contributes to the existing knowledge by enhancing our understanding of the processes via which BIM positively influences project outcomes.

The impact of risk management implementation on the effectiveness of SAI’s internal audit function

Internal audits play an important role in monitoring the achievement of organizational objectives. However, research on the factors influencing the success of internal audits remains limited. This study aims to investigate the effectiveness of BPK’s Itama (The Inspectorate General of the Audit Board of the Republic of Indonesia) functions, hypothesized to be influenced by risk management policy implementation. This study employs quantitative methods; data were collected via surveys and analyzed using structural equation modeling (SEM) to test theory-based hypotheses. Results reveal a significant positive correlation between risk management policy implementation and the effective functioning of Itama. Additionally, the study identifies key factors determining the success of risk management policy implementation: economic, social, and political conditions. Therefore, internal auditors of supreme audit institutions must consider these external factors when implementing risk management policies. This study contributes to understanding internal audit effectiveness by highlighting the impact of external economic, social, and political conditions.

Implementasi E-Government pada Aplikasi Pds-Pajak Daerah Kabupaten Sidoarjo

Implementation of E-Government can improve the quality of public services through the use of information and communication technology in the government administration process. The Sidoarjo Regency Tax Services Agency also takes advantage of technological developments by issuing the Sidoarjo Regional PDS-Tax Application. The PDS Application System has been implemented at BPPD to improve services in tax activities. The success of implementation can be seen from the positive response given by Taxpayers. Although there are still obstacles faced in implementing the PDS application, such as not everyone being technologically literate. These obstacles are not a serious problem, because BPPD Sidoarjo Regency carries out outreach at all times, both directly and indirectly. The theory used is the theory of policy implementation put forward by Merilee S. Grindle. The method used is a descriptive research method with a qualitative approach. The data collection technique is through field studies consisting of observation, interviews and documentation. The results of the research show that the implementation of the PDS Application Policy is going well, this is made clear by the implementation being right on target, the socialization carried out is going well as seen from Taxpayers who already know and use the PDS Application in carrying out tax activities.

Implementasi E-Government pada Aplikasi Pds-Pajak Daerah Kabupaten Sidoarjo

Implementation of E-Government can improve the quality of public services through the use of information and communication technology in the government administration process. The Sidoarjo Regency Tax Services Agency also takes advantage of technological developments by issuing the Sidoarjo Regional PDS-Tax Application. The PDS Application System has been implemented at BPPD to improve services in tax activities. The success of implementation can be seen from the positive response given by Taxpayers. Although there are still obstacles faced in implementing the PDS application, such as not everyone being technologically literate. These obstacles are not a serious problem, because BPPD Sidoarjo Regency carries out outreach at all times, both directly and indirectly. The theory used is the theory of policy implementation put forward by Merilee S. Grindle. The method used is a descriptive research method with a qualitative approach. The data collection technique is through field studies consisting of observation, interviews and documentation. The results of the research show that the implementation of the PDS Application Policy is going well, this is made clear by the implementation being right on target, the socialization carried out is going well as seen from Taxpayers who already know and use the PDS Application in carrying out tax activities.

From theory to practice in implementation science: qualitative insights from the implementation model developed by a commercial eMental Health provider

BackgroundAlthough eMental health interventions are a viable solution to address disparities in access to mental healthcare and increase its efficiency, they still face challenges of implementation. Literature highlights numerous barriers such as diffusion of responsibility and unclear expectations of what implementation entails might hinder this process. While research mostly focuses on analyzing these barriers, there is an urgent need to increase uptake in practice. In turn, commercial companies focus mostly on increasing uptake, while overlooking research outputs. To bridge the gap between research and practice, attention to how implementation occurs in practice is required. This study investigates “Make it Happen” (MiH), the implementation model developed by the eMental Health company Minddistrict, aiming to gain more insight into operationalizing implementation frameworks by 1) describing MiH and its conceptual underpinnings, and 2) gaining lessons learned from the development of MiH. Ultimately, this work aims at improving existing scientific frameworks by extending them with knowledge from practice.MethodsFirst, individual interviews and focus groups with Minddistrict implementation managers were performed. Second, individual interviews with project leads in mental healthcare organizations that were involved in the implementation of Minddistrict were conducted. Within Minddistrict, 7 implementation managers and account managers were involved, in addition to 11 project leads from mental healthcare organizations. Data were elaborated with thematic analysis.ResultsA comprehensive description of MiH and its 5 main phases was achieved. During the 1) Onboarding phase, implementing organizations are guided by Minddistrict to build a team responsible for implementation, which then 2) designs patient and client journeys, 3) builds, tailors and configures their offer, 4) trains key-users and, 5) evaluates the success of implementation. All participants had extensive and aligned definitions and articulated expectations on implementation. Points of improvement for the model such as role ambiguity and excessive workload were identified. As strengths, internal motivation and good relationships with the provider were valued.ConclusionThe present study highlights the importance of clear role division and stakeholder engagement in implementation processes, and suggest that a strong collaboration between companies and academia could optimize implementation efforts and ensure a better fit between humans, context, and technologies.

Advanced practice nursing implementation in France: A mixed-method study.

To describe advanced practice nursing (APN) in the French healthcare landscape and to provide insights on how the role is defined and implemented and how the role is perceived by physicians. A mixed-method approach incorporating qualitative and quantitative data to offer a global understanding of APN implementation in France was used. Data were collected through questionnaires and interviews with APNs and physicians in diverse healthcare settings in France. The questionnaire assessed the roles, relationships with physicians and patients and the perceived implementation success of APNs. In-depth interviews explored experiences, definitions, challenges and perspectives of APNs. A thematic analysis was applied to the qualitative data to complete the quantitative exploration. Descriptive analyses were performed for quantitative data. A total of 41 APNs and 12 physicians were involved in this study between December 2022 and March 2023. The findings underscore APN as a pivotal, independent profession integrating advanced clinical expertise and interprofessional skills. The challenges encountered by APNs include role ambiguity, ongoing resistance and the need to address institutional barriers. Despite the fact that 73.2% of APNs reported that their role was well implemented, only 17.1% had clearly defined roles at the outset. This study revealed the dynamic and evolving nature of APN in France, highlighting its challenges and opportunities. Despite facing role ambiguity and resistance, APNs play a crucial role in the healthcare system. The results highlight the need for specific interventions to tackle challenges and facilitate successful integration of APN. These insights lay a foundation for future research and interventions aimed at boosting the impact and acceptance of APN in France, potentially influencing policy modifications and professional development. Problem Addressed: The study aimed to enhance comprehension of the implementation and role of advanced practice nursing (APN) in France. It focused on defining APN in the French context, identifying barriers and facilitators to its implementation and evaluating its impact. The study revealed that APN in France is evolving with expanded competencies and clinical autonomy, but faces challenges like role ambiguity and professional resistance. Key findings include the successful integration of APNs in healthcare settings, positive relationships with medical doctors and patient satisfaction. However, the study also highlighted the necessity to resolve role ambiguity and to improve the understanding and acceptance of APN roles among healthcare professionals for successful APN integration. Impact of the research: This research will primarily impact healthcare systems and policy-making in France, guiding the future development and integration of APN roles. It is also relevant for healthcare professionals, particularly nurses and physicians, by providing information about the evolving nature of APN and its benefits in patient care. Globally, the study contributes to the broader discourse on APN, offering insights that could inform APN implementation strategies in other countries facing similar healthcare challenges. COREQ-STROBE. No patient or public contribution.

Patient self-reported pain and nausea via smartphone following day care surgery, first year results: An observational cohort study.

Contact with the hospital is usually limited for patients after day care surgery. Dedicated smartphone applications can improve communication and possibly enhance outcomes. The objective of this retrospective study was to evaluate patients' self-reported pain and nausea and assess the success of routine implementation of a smartphone application for outcome reporting. During preoperative assessment, patients were instructed to download and activate the smartphone application to report pain, nausea and to be in contact with the hospital after discharge. Main outcome was the number of patients actively using the smartphone application and the incidence of pain and nausea on postoperative day 1 to 7. In total, 4952 patients were included in the study. A total of 592 (12%) participants downloaded the application, of whom 351 (7%) were active users. A total of 4360 (88%) participants refrained from downloading the application. 56% (2,769) were female, the median age was 46 (18-92), and 4286 (87%) were classified as 1 or 2 American Society of Anesthesiologists Physical Status (ASA). Postoperative pain was experienced by 174 (76%) of 229 active users on postoperative day (POD) 1 and decreased to 44 (44%) of 100 active users on POD7. Postoperative nausea was experienced by 63 (28%) of 229 active users on POD1 and decreased to 12 (12%) of 100 active users on POD7. Female sex (p .000), socioeconomic status (p .001), and surgical severity (p .001) showed statistically significant differences between active users, non-active users, and non-downloaders. Most patients active with the application experienced pain and nausea on the first and second day after discharge. Only a minority of the patients used the application. Those who used it were satisfied with the possibilities offered to them. Future research should focus on increasing the uptake and effect of this application on the quality of recovery.

Measuring the impact of lean implementation on BIM and project success: case of construction firms

PurposeThe main purpose of this study is to reveal the degree of association between lean, building information modeling (BIM) and construction project success. The study further intends to provide strategies for high and low associations of the factors.Design/methodology/approachLean construction and BIM are two important applications that have recently gained popularity in terms of enhancing project success. Considering this impact, this study investigates the synergy between lean construction and BIM and determines to what extent these two contribute to the success of the projects. As a first step, lean, BIM and project success were examined based on an in-depth literature review. In the second stage, a structural equation model (SEM) was established to reflect the relationship among these three through hypotheses. Then, a questionnaire was designed and administered to the construction professionals experienced in both lean and BIM implementation. The SEM was tested using Analysis of Moment Structures (AMOS), an SPSS tool.FindingsThe results indicated that lean implementation has a significant and positive impact on BIM implementation and project success. On the other hand, BIM implementation had a lower significant impact on project success than lean implementation construct.Research limitations/implicationsThe results of this study can be used by both policymakers and industry practitioners in terms of developing strategies for effectively using both lean and BIM. The researchers can further develop other implementation models to investigate whether these concepts are more effective in increasing project success when used integratively.Originality/valueThis study considers both the impact of lean and BIM on project success through input from construction practitioners working on large projects. This way, the study fosters the use of lean, BIM or lean–BIM together in construction projects to enhance project success.

Designing an ESP Syllabus for International Relations: Insights from a Needs Analysis Study

The distinct research of ESP (English for Specific Purposes) for International Relations (IR) students is rarely explored despite the growing need of ESP for this particular group of students. These students must demonstrate proficiency in specific language competences for a variety of purposes, including arguing, negotiating, and participating in IR-related debates. Facilitating students' ownership of the necessary capabilities is critical to ensuring that they acquire them successfully.This study aims to depict the important use of needs analysis in syllabus making for EFIR (English for International Relations). A decent preparation of the syllabus contributes to the success of the ESP implementation. In this study, the researcher involved students and expert practitioners’ intuitions as the sources of the needs analysis. The participants of this research were 108 IR students and two expert practitioners. These students were asked to filled out a questionnaire while some more-detailed interviews were conducted by involving nine stand out students that represent high, middle and low-achiever students. In addition, the four expert practitioners that consist of two lecturers and two IR graduates were interviewed to enrich the needs analysis data. All of the data were analyzed using quantitative and qualitative analysis. The finding of this study is the syllabus that can be applied for universities that provide the same ESP program for its students. The syllabus that was constructed by considering the stakeholders' needs analysis hopefully could be a useful guidance for EFIR implementation.

The effect of multisector integration communication on empowerment in rural areas

Background: Empowering impoverished communities has been a long-standing endeavor. However, the persistent prevalence of poverty still affects approximately 25 million individuals (BPS, 2023). Nevertheless, the government continues its relentless efforts to minimize the presence of impoverished families. One of the strategies employed is the implementation of the Family Hope Program (PKH). PKH stands as a program that has effectively fulfilled its mission. Various research studies have been conducted to comprehend the processes, mechanisms, impacts, and societal implications. However, research exploring the cross-sectoral communication aspects, elaborating on the involvement of stakeholders and PKH implementers spanning multiple institutions, remains lacking. Purpose: This research aims to measure the level of influence of multi-sectoral integration communication on the performance of individual PKH implementers. Methods: The employed methodology is an explanatory survey. The surveyed population comprises civil servants engaged in PKH. The population size consists of 80 individuals. Probability sampling is utilized as the sampling technique, with a sample size of 44 respondents, determined using the Slovin method. Hypothesis testing employs Path Analysis. Results: The research findings indicate a significant influence of cross-sectoral communication factors, encompassing organizational member perceptions, organizational strategies, communication climate, media quality, information accessibility, information dissemination, information accuracy, and organizational culture, on the performance of individual PKH implementers. Conclusion: Organizational member performance emerges as a critical aspect for the success of PKH implementation. The research results demonstrate that this performance is influenced by several factors, including information accessibility, media quality, information accuracy, organizational communication climate, organizational culture, information dissemination, and organizational strategies in the execution of the PKH program. Implications: The success of PKH is contingent upon the performance of individual members from collaborating institutions. Enhancing the effectiveness and efficiency of individual performance factors can be achieved by synergizing with cross-sectoral communication components.

Evaluation of local language learning in the Limola language revitalization

Limola is one of Indonesia’s endangered languages, makingit imperative to pass on Limola culture and language to a younger generation. The Limolalanguage revitalization program in Sassa Village, Baebunta District, North Luwu Regency, South Sulawesi Province seeks to preserve the Limola language and culture by teaching the younger generation Limola drama, songs, and poetry. Therefore, this study evaluates the key performance indicators of Limola culture and language learning in the revitalization program to identify the identity of the To Limola society after learning Limola culture and language, and (2) evaluate the implementation of the Limola language community-based revitalization. This study used a descriptive qualitative approach that involved desk study data collection techniques and in-depth interviews with the participants and instructors from the Limola language revitalization program. A sociolinguistic in termsof language and identity research approach was taken to analyzethe data and explore the local content in the language learning materials. The data analysis was also based on the CIPP (Context, Input, Process, and Product) evaluation model and language progress indicators to evaluate the implementation success. The results revealed that the Limola revitalization language learning materials have local content that strongly reflects the identity of the To Limola society. While the Limola language revitalization participants learned both the Limola language and culture, the implementation did not appear to have had a significant impact on increasing the interest of the younger generation in using the Limola language.

Factors Affecting the Implementation Success of Human Resources Management Information System (HRMIS) in the organization: A Literature Review Study

Factors Affecting the Implementation Success of Human Resources Management Information System (HRMIS) in the organization: A Literature Review Study

EFFECTIVENESS OF IMPLEMENTING THE TEACHER PROFESSION CERTIFICATION POLICY IN KEBONPEDES DISTRICT

One crucial element in advancing education is the presence of educators with high professionalism. Considering the rough overview of the current condition of teachers, the situation is very concerning due to their low motivation and competence. Addressing this, this research aims to: (1) Examining the impact of teacher motivation on the success of teacher certification policy implementation; (2) Evaluate teacher competence in the success of implementing the teacher professional certification policy; (3) Investigate the combined influence of motivation and teacher competence on the success of implementing the teacher professional certification policy. The research analysis unit is in the Kebonpedes Subdistrict of Sukabumi Regency. The research subjects are certified teachers. A total of 66 individuals, equivalent to 50% of the total population of 132 individuals, were selected as samples. The eeffectiveness of implementing the teacher professional certification policy is proven to be influenced by the level of motivation and competence of the teachers.

EFFECTIVENESS OF IMPLEMENTING THE TEACHER PROFESSION CERTIFICATION POLICY IN KEBONPEDES DISTRICT

One crucial element in advancing education is the presence of educators with high professionalism. Considering the rough overview of the current condition of teachers, the situation is very concerning due to their low motivation and competence. Addressing this, this research aims to: (1) Examining the impact of teacher motivation on the success of teacher certification policy implementation; (2) Evaluate teacher competence in the success of implementing the teacher professional certification policy; (3) Investigate the combined influence of motivation and teacher competence on the success of implementing the teacher professional certification policy. The research analysis unit is in the Kebonpedes Subdistrict of Sukabumi Regency. The research subjects are certified teachers. A total of 66 individuals, equivalent to 50% of the total population of 132 individuals, were selected as samples. The eeffectiveness of implementing the teacher professional certification policy is proven to be influenced by the level of motivation and competence of the teachers.

Web-based occupational stress prevention in German micro- and small-sized enterprises – process evaluation results of an implementation study

BackgroundStructural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE.ObjectiveThe aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention (“System P”) and to identify potential barriers for its uptake and use in MSE in Germany.MethodsThis study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders.ResultsPart I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8. Costs: The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed.ConclusionsAlthough System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution.⁺ Full project name“PragmatiKK – Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben” (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises).Trial registrationGerman Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.