The spending they began must have done some good to cushion the recession, but either through a failure of theory or a failure of implementation, their lever was not as powerful as they promised.
Using difference in difference analysis, a quantitative approach comparing geographical areas, an evaluation of the Lincolnshire Delivering Choice project found that Delivering Choice had a positive impact on decreasing NHS costs [ 15] while other evaluations of Delivering Choice projects were interview studies conducted with professionals about barriers and levers to implementation [ 12- 14].
Mixed effects regression analyses indicated that both clinician attitudes and an organization's implementation climate may be important levers for interventions seeking to increase clinician exposure use.
Known barriers and/or levers to effective implementation of services to promote healthy weight among obese and overweight children were considered in interpreting the data.
Notwithstanding the limitations of our study, we believe that the TDF can usefully be used by those wanting to develop strategies to address specific barriers and levers to the implementation of a range of clinical quality interventions.
Participants in this study emphasised that issues of training interpreters, monitoring professional practice, financial compensation for interpreters and the challenges of organising bookings for interpreted consultations may act as levers or barriers to implementation of existing guidelines.
Control over the details of program implementation is limited, so a primary lever for policymakers at the federal level will be the decision of whether the program taken as a whole—should be continued or expanded.
This study aimed to design a multicomponent intervention to improve delirium care in long-term care facilities for older people in the UK and to identify the levers and barriers to its implementation in practice.
Strong beliefs in the power of the financial lever or perceptions of potential implementation difficulties for non-financial interventions could explain this policy choice.
In Lao PDR, despite the implementation problems, it is still seen as a lever for securing land tenure, rationalizing extension services provision, and more recently, for implementing 'Reduced Emissions from Deforestation and Forest Degradation' (REDD) schemes.
