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Table 6 Results of SWOT analysis for evaluating and communicating the effectiveness of chronic disease management programs

From: The prevention and management of chronic disease in primary care: recommendations from a knowledge translation meeting

Strengths to leverage Weaknesses to address
Stakeholders, Partnerships, and Knowledge Transfer of evaluation results
Legitimate interest of potential community partners e.g. pharmacists
Sincere interest in the program on the part of referring doctors, stakeholders, and clinicians
The evaluation provides a natural feedback mechanism. Patients who see an improvement in their health bring this information back to their family doctors
Evaluation process
Similarity of programs (all based on CCM)
Similarity of tools allows for the pooling of results to increase sample sizes and allow for comparison
Funding
Lack of resources for evaluation
Communication
Lack of referrals to the program and difficulty in reaching the target population (small sample size)—expressed as a lack of marketing and communication skills
Communication procedure are not well defined: need a mechanism to feed back patient outcomes to physicians and for them to communicate with the program to ask questions and see how their patient is doing
Stakeholders, partnerships, and knowledge transfer of evaluation results
Physicians not convinced about the efficacy of an interdisciplinary approach
Difficulty in legitimizing the projects to key actors, often family doctors
Difficulty in feeding back information about evaluation results to clinicians
Evaluation process
Different indicators between projects
 Need to establish key minimal indicators that must be collected throughout implementation
Evaluation timeline too short
Short timeline means incomplete implementation
Lost participation leading to missing data
Difficulty involving clinicians in the data collection process
The act of evaluating is seen as an intervention in itself. Good for implementation but might introduce bias for evaluation
Unclear definition of chronic diseases (ex. is cancer a chronic disease?)
Cannot ignore notion of cost-benefits as many stakeholders are interested in knowing about the long-term feasibility at the institution level
Lack of technology-supported tool
All stakeholders have different things they want to measure, achieve, and evaluate. This is hard to consolidate
Opportunities to optimise Threat to mitigate
Stakeholders, Partnerships, and Knowledge Transfer of evaluation results Funding
Improve involvement of family doctors to ensure their participation and ensure their sense that they have a role to play Not enough funding for an evaluation to prove a program’s long-term effectiveness, which is needed to seek more funding
Integration with local and community resources (ex. YMCA, pharmacists, gyms, kinesiologists)—need to get creative in terms of partnerships
Make use of evaluation results to legitimize the projects to seek out funding and attract involvement of more people
Planning and financing of research—not enough resources to see the evaluation all the way through (implementation, evaluation, diffusion of results)
Stakeholders, partnerships, and knowledge transfer of evaluation results
Not enough publication of results to help decision makers
Evaluation process
Danger of saturating certain areas with too many similar projects
Synthesize the facilitating factors and challenges experienced by all projects
Pursue and create new partnerships by bringing down barriers with the community
Utilize existing resources like local regional tables to promote important networking opportunities
Bring professionals together to standardize care and information given to patients While there are similarities in evaluation tools, this isn’t always the case—it will be a challenge to harmonize tools and projects in the future
Communication
Improve marketing and communication (ex. work with students). This can help bring awareness to the project and help researchers disseminate results
Clinical information systems could help in data collection—these are not available for most projects
Obtaining an adequate control group
Resistance to the evaluation of programs and of quality of care
Improve working conditions for professionals to incite them to participate in the program
Evaluation process
Need to evaluate costs - both cost of implementation and cost- effectiveness of project  
Do better job of evaluating physician dropout rates