Nurses’ Readiness Did Not Predict Uptake of a Digital Child Obesity Prevention Program

An observational prospective study published in BMC Health Services Research examined whether organizational readiness among Swedish child healthcare nurses predicted the early adoption of MINISTOP, an evidence-based digital health promotion and obesity prevention program rolled out at scale in 2023. The study, led by Maria Fagerström and colleagues, found no statistically significant associations between any of the measured readiness dimensions and how many families actually gained access to the program, a result the authors say illustrates the complexity of organizational readiness as a construct.

Organizational readiness was measured at baseline by 83 nurses from 37 centers using the six-dimension E-Ready questionnaire, which treats readiness as a multidimensional construct reflecting both individual and collective aspects. Adoption of MINISTOP was assessed 19 weeks later through registration data, specifically the number of families who gained access to the program.

The baseline picture was mixed. Nurses reported a high degree of readiness for the conditions for change at the workplace, individual conditions for change, and workplace attitudes dimensions. Readiness was rated medium for perceived support among management, and low for two dimensions: readiness among colleagues and perceived consequences on the status quo. These descriptive results suggest that while nurses individually felt prepared for the digital program, collective and perceived-disruption concerns were weaker at the start of implementation.

Despite that variation across dimensions, the regression analysis found no statistically significant associations between any E-Ready dimension and adoption at 19 weeks. The authors did, however, observe positive estimates pointing toward two dimensions: readiness among colleagues (IRR = 1.1, p = 0.05) and conditions for change at the workplace (IRR = 1.1, p = 0.08). Because these estimates did not reach conventional thresholds of statistical significance, they should be interpreted cautiously, but the pattern suggests that collective aspects of readiness may warrant closer study as potential correlates of implementation outcomes.

The study’s conclusion is deliberately measured: no statistically significant associations were identified between organizational readiness and adoption in this early implementation window. The authors note that longitudinal studies using repeated readiness assessments are needed to clarify how organizational readiness relates to implementation outcomes over time, since a single baseline measurement followed by one adoption checkpoint cannot capture how readiness evolves or how it might influence uptake at later stages. As an observational study of nurses within one national implementation of a single digital program, the findings speak to the Swedish child healthcare context in 2023 and do not establish that readiness is irrelevant to digital health implementation; rather, they highlight that the relationship, if any, is more complicated than current empirical data support, a gap the authors identify as a broader limitation in implementation science.

Subject of Research: Organizational readiness and early adoption of a digital obesity prevention program in Swedish child healthcare

Article Title: Exploring organizational readiness for the early adoption of a digital obesity prevention program in Swedish child healthcare: an observational prospective study

Article References: Fagerström, M., Festin, K., Lundgren, M., Löf, M., Melin, J., Neher, M., Nyström, C. D., & Thomas, K. (2026). Exploring organizational readiness for the early adoption of a digital obesity prevention program in Swedish child healthcare: an observational prospective study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15953-6

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15953-6

Keywords: organizational readiness, implementation science, digital health, obesity prevention, child healthcare, MINISTOP, Sweden, nurses, E-Ready questionnaire, adoption, Exploring, organizational