Table 4

Facilitators and barriers identified at the implementation phase

Themes	Facilitators	Barriers
Management and collaboration	Common understanding of long-term nature of AIM process Cooperation with academic institution Enthusiasm from partners Local partnerships Partner's network Partners organised and respected Routine monitoring and evaluation from outset	Cooperation problems with existing partners Failure by partners to meet deadlines Internal organisational changes Poor internal understanding of implementation Problems establishing partnerships Lack of clarity regarding partner roles Resistance among partners to comply with the central scheme Lack of monitoring
Resources	Availability of funding Fundraising support from local organisations Funds allocated to media campaign Staff training as part of scheme set-up In kind support from professionals Production and distribution of supporting educational materials	Lack of funding Lack of sufficiently trained personnel Heavy workload or fear of increased workload Lack of volunteers Short time frame Lack of data
Leadership	Good internal leadership of consortium: central administration, support and information Stability of key figures and personnel Interministerial cooperation Committed champions National/top–down initiative	Challenges for national organisation to act locally Policy maker misunderstanding problem Resignation of champion
Nature of the intervention	Robust intervention Pilot phase with good results Cofinancing/cobenefits for partners Links to other projects Existing intervention with own resources (protocol/educational material) No-charge nature of intervention (eg, free equipment and fitting) Action taken from beginning to properly address target population Strong research base and reliable data Compliance with intervention easy and not too expensive Legal clarity	Difficulties encountered when adapting intervention to setting Large and complex interventions Efficacy of recommended items questionable Voluntary nature of participation (eg, voluntary standards) Misunderstanding/lack of resources among enforcers Confusion among consumers
Political, social and cultural environment	Change in national agenda Better designed safety products on the market Existing legislation	Change in political climate Lack of safety culture among population Circumstances relating to armed conflict
Visibility	Interest in safety gave rise to a new market for safety equipment Problem addressed was widely recognised Publicity
Nature of the injury problem		Taboo subject (eg, suicide) Relatively low number of child deaths

AIM, adoption, implementation and monitoring.