Open Access Open Badges Research article

Intervention mapping for the development of a strategy to implement the insurance medicine guidelines for depression

Feico Zwerver123*, Antonius JM Schellart12, Johannes R Anema12, Kathelijne C Rammeloo3 and Allard J van der Beek12

Author Affiliations

1 VU University Medical Center, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands

2 Research Center for Insurance Medicine, collaboration between AMC-UWV-VUmc, Amsterdam, The Netherlands

3 Dutch National Institute for Employee Benefits Schemes, Amsterdam, The Netherlands

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BMC Public Health 2011, 11:9  doi:10.1186/1471-2458-11-9

Published: 5 January 2011



This article describes the development of a strategy to implement the insurance medicine guidelines for depression. Use of the guidelines is intended to result in more transparent and uniform assessment of claimants with depressive symptoms.


The implementation strategy was developed using the Intervention Mapping (IM) method for alignment with insurance-medical practice. The ASE behavioural explanation model (Attitude, Social Influence and Self-Efficacy) was used as theoretical basis for the development work. A literature study of implementation strategies and interviews with insurance physicians were performed to develop instruments for use with the guideline. These instruments were designed to match the needs and the working circumstances of insurance physicians. Performance indicators to measure the quality of the assessment and the adherence to the guidelines were defined with input from insurance physicians.


This study resulted in the development of a training course to teach insurance physicians how to apply the guidelines for depression, using the aforementioned instruments. The efficacy of this training course will be evaluated in a Randomized Controlled Trial.


The use of IM made it possible to develop guideline support instruments tailored to insurance medical practice.