Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study
Abstract Background Peer support is an essential part of recovery-oriented care worldwide. Contextual factors have an impact on the implementation of peer support work. However, research has paid little attention to similarities and differences of implementation factors in settings varying by income...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-024-10543-w |
| _version_ | 1827328094329896960 |
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| author | Maria Haun Inbar Adler Ben-Dor Cerdic Hall Jasmine Kalha Palak Korde Galia Moran Annabel S. Müller-Stierlin Jackline Niwemuhwezi Rebecca Nixdorf Bernd Puschner Mary Ramesh Ashleigh Charles Silvia Krumm |
| author_facet | Maria Haun Inbar Adler Ben-Dor Cerdic Hall Jasmine Kalha Palak Korde Galia Moran Annabel S. Müller-Stierlin Jackline Niwemuhwezi Rebecca Nixdorf Bernd Puschner Mary Ramesh Ashleigh Charles Silvia Krumm |
| author_sort | Maria Haun |
| collection | DOAJ |
| description | Abstract Background Peer support is an essential part of recovery-oriented care worldwide. Contextual factors have an impact on the implementation of peer support work. However, research has paid little attention to similarities and differences of implementation factors in settings varying by income-level and cultural values. The aim of this study is to assess the factors influencing the implementation of a peer support intervention across study sites in low-, middle- and high-income countries in line with the Consolidation Framework for Implementation Research (CFIR). Method 6 focus groups with a total of 54 key informants with relevant contextual (organisational) knowledge regarding implementation facilitators and barriers were conducted at six study sites Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be’er Sheva (Israel), and Pune (India) before and 1.5 years after the start of UPSIDES peer support. Transcripts were analysed using qualitative content analysis. Results Across study sites key informants reported benefits of peer support for service users and peer support workers as implementation facilitators. At study sites with lower resources, reduced workload for mental health workers and improved access to mental health services through peer support were perceived as implementation facilitators (CFIR Domain 1: Intervention characteristics). The degree of engagement of mental health workers (CFIR Domain 3: Inner Setting/Domain 4: Individuals involved) varied across study sites and was seen either as a barrier (low engagement) or a facilitator (high engagement). Across study sites, adequate training of peer support workers (CFIR Domain 5: Implementation process) was seen as animplementation facilitator, while COVID-19 as well as low resource availability were reported as implementation barriers (CFIR Domain 2: Outer setting). Conclusions This study highlights the importance of considering contextual factors when implementing peer support, including previous experience and perceived benefits. Particular attention should be given to organisational benefits such as workload reduction and the allocation of sufficient resources as key drivers in LMICs. In HICs, the potential of organisational benefits for successful implementation should be further investigated and promoted. |
| first_indexed | 2024-03-07T15:11:59Z |
| format | Article |
| id | doaj.art-59644093620246d999686d9927c3d1bd |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-07T15:11:59Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-59644093620246d999686d9927c3d1bd2024-03-05T18:06:08ZengBMCBMC Health Services Research1472-69632024-02-0124111210.1186/s12913-024-10543-wPerspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site studyMaria Haun0Inbar Adler Ben-Dor1Cerdic Hall2Jasmine Kalha3Palak Korde4Galia Moran5Annabel S. Müller-Stierlin6Jackline Niwemuhwezi7Rebecca Nixdorf8Bernd Puschner9Mary Ramesh10Ashleigh Charles11Silvia Krumm12Department of Psychiatry II, Ulm UniversityDepartment of Social Work, Ben Gurion University of the NegevEast London NHS Foundation TrustCentre for Mental Health Law and Policy, Indian Law SocietyCentre for Mental Health Law and Policy, Indian Law SocietyDepartment of Social Work, Ben Gurion University of the NegevDepartment of Psychiatry II, Ulm UniversityButabika National Referral HospitalDepartment of Psychiatry and Psychotherapy, University Medical Center Hamburg-EppendorfDepartment of Psychiatry II, Ulm UniversityDepartment of Health Systems, Impact Evaluation and Policy, Ifakara Health InstituteSchool of Health Sciences, Institute of Mental Health, University of NottinghamDepartment of Psychiatry II, Ulm UniversityAbstract Background Peer support is an essential part of recovery-oriented care worldwide. Contextual factors have an impact on the implementation of peer support work. However, research has paid little attention to similarities and differences of implementation factors in settings varying by income-level and cultural values. The aim of this study is to assess the factors influencing the implementation of a peer support intervention across study sites in low-, middle- and high-income countries in line with the Consolidation Framework for Implementation Research (CFIR). Method 6 focus groups with a total of 54 key informants with relevant contextual (organisational) knowledge regarding implementation facilitators and barriers were conducted at six study sites Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be’er Sheva (Israel), and Pune (India) before and 1.5 years after the start of UPSIDES peer support. Transcripts were analysed using qualitative content analysis. Results Across study sites key informants reported benefits of peer support for service users and peer support workers as implementation facilitators. At study sites with lower resources, reduced workload for mental health workers and improved access to mental health services through peer support were perceived as implementation facilitators (CFIR Domain 1: Intervention characteristics). The degree of engagement of mental health workers (CFIR Domain 3: Inner Setting/Domain 4: Individuals involved) varied across study sites and was seen either as a barrier (low engagement) or a facilitator (high engagement). Across study sites, adequate training of peer support workers (CFIR Domain 5: Implementation process) was seen as animplementation facilitator, while COVID-19 as well as low resource availability were reported as implementation barriers (CFIR Domain 2: Outer setting). Conclusions This study highlights the importance of considering contextual factors when implementing peer support, including previous experience and perceived benefits. Particular attention should be given to organisational benefits such as workload reduction and the allocation of sufficient resources as key drivers in LMICs. In HICs, the potential of organisational benefits for successful implementation should be further investigated and promoted.https://doi.org/10.1186/s12913-024-10543-wPeer supportImplementation facilitators and barriersConsolidated Framework for Implementation Research (CFIR)Low-, middle- and high-income countriesFocus groups |
| spellingShingle | Maria Haun Inbar Adler Ben-Dor Cerdic Hall Jasmine Kalha Palak Korde Galia Moran Annabel S. Müller-Stierlin Jackline Niwemuhwezi Rebecca Nixdorf Bernd Puschner Mary Ramesh Ashleigh Charles Silvia Krumm Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study BMC Health Services Research Peer support Implementation facilitators and barriers Consolidated Framework for Implementation Research (CFIR) Low-, middle- and high-income countries Focus groups |
| title | Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study |
| title_full | Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study |
| title_fullStr | Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study |
| title_full_unstemmed | Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study |
| title_short | Perspectives of key informants before and after implementing UPSIDES peer support in mental health services: qualitative findings from an international multi-site study |
| title_sort | perspectives of key informants before and after implementing upsides peer support in mental health services qualitative findings from an international multi site study |
| topic | Peer support Implementation facilitators and barriers Consolidated Framework for Implementation Research (CFIR) Low-, middle- and high-income countries Focus groups |
| url | https://doi.org/10.1186/s12913-024-10543-w |
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