OBJECTIVES : Although substantial progress has been made in the last decades in eliminating iodine deficiency disorders (IDD) in Europe, challenges remain due to fragmentation and diversity of IDD prevention and monitoring programs. However, barriers against the implementation and continuation of those programs remain unclear. Therefore, the objective of our study was to identify potential barriers for implementing or continuing IDD prevention and monitoring programs and to suggest solutions.

METHODS : We identified potential participants with expertise and experience in relevant fields including policy makers, healthcare professionals, health scientists, and patient representatives from all European countries. A modified Delphi method was conducted with open-ended questions and item ranking to achieve group consensus on barriers and solutions. The answers of the Delphi rounds were analyzed using qualitative content analysis and descriptive statistical analysis methods.

RESULTS : 80 experts from 36 countries and different fields of work participated in the first Delphi round, 52 in the second and 46 in the third. Potential barriers for the implementation of national prevention and monitoring programs include challenges in the fields of knowledge, information, implementation, management, communication and cooperation. Barriers for the implementation of a pan-European prevention program are differences between the countries, lack of political support and challenges in the field of implementation and management. Solutions addressing these barriers include cooperation with different stakeholders, gaining knowledge, sharing information, the development of a European program with national specification, European guidelines/recommendations and European monitoring.

CONCLUSIONS : In our study, we derived key information and first insights with regard to barriers against IDD prevention programs from a broad range of stakeholders. The results will raise awareness of challenges and potential solutions for the implementation of national and pan-European IDD prevention and monitoring program. This information may help decision makers in health policy for the development of IDD prevention strategies.