IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use
Abstract Background Despite the potential of digital health interventions to improve the delivery of psychoeducation to people with mental health problems and their relatives, and substantial investment in their development, there is little evidence of successful implementation into clinical practic...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-5002-4 |
| _version_ | 1818133194103324672 |
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| author | Fiona Lobban Duncan Appelbe Victoria Appleton Julie Billsborough Naomi Ruth Fisher Sheena Foster Bethany Gill David Glentworth Chris Harrop Sonia Johnson Steven H. Jones Tibor Zoltan Kovacs Elizabeth Lewis Barbara Mezes Charlotte Morton Elizabeth Murray Puffin O’Hanlon Vanessa Pinfold Jo Rycroft-Malone Ronald Siddle Jo Smith Chris J. Sutton Pietro Viglienghi Andrew Walker |
| author_facet | Fiona Lobban Duncan Appelbe Victoria Appleton Julie Billsborough Naomi Ruth Fisher Sheena Foster Bethany Gill David Glentworth Chris Harrop Sonia Johnson Steven H. Jones Tibor Zoltan Kovacs Elizabeth Lewis Barbara Mezes Charlotte Morton Elizabeth Murray Puffin O’Hanlon Vanessa Pinfold Jo Rycroft-Malone Ronald Siddle Jo Smith Chris J. Sutton Pietro Viglienghi Andrew Walker |
| author_sort | Fiona Lobban |
| collection | DOAJ |
| description | Abstract Background Despite the potential of digital health interventions to improve the delivery of psychoeducation to people with mental health problems and their relatives, and substantial investment in their development, there is little evidence of successful implementation into clinical practice. We report the first implementation study of a digital health intervention: Relatives Education And Coping Toolkit (REACT), into routine mental healthcare. Our main aim was to identify critical factors affecting staff uptake and use of this online self-management tool for relatives of people with psychosis or bipolar. Methods A mixed-methods, theory-driven (Normalisation Process Theory), iterative multiple case study approach using qualitative analysis of interviews with staff and quantitative reporting of uptake. Carer researchers were part of the research team. Results In all, 281 staff and 159 relatives from Early Intervention teams across six catchment areas (cases) in England registered on REACT; 129 staff took part in qualitative interviews. Staff were positive about REACT helping services improve support and meet clinical targets. Implementation was hindered by: high staff caseloads and difficulties prioritising carers; perception of REACT implementation as research; technical difficulties using REACT; poor interoperability with trust computer systems and care pathways; lack of access to mobile technology and training; restricted forum populations; staff fears of risk, online trolling, and replacement by technology; and uncertainty around REACT’s long-term availability. Conclusions Digital health interventions, such as REACT, should be iteratively developed, evaluated, adapted and implemented, in partnership with the services they aim to support, and as part of a long term national strategy to co-develop integrated technology-enabled mental healthcare. Implementation strategies must instil a sense of ownership for staff and ensure they have adequate IT training, appropriate governance protocols for online working, and adequate mobile technologies. Wider contextual factors including adequate funding for mental health services and prioritisation of carer support, also need to be addressed for successful implementation of carer focussed digital interventions. Trial registration Study registration: ISCTRN 16267685 . |
| first_indexed | 2024-12-11T08:48:51Z |
| format | Article |
| id | doaj.art-fd751544955f41d082f3422b0dd124f9 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T08:48:51Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-fd751544955f41d082f3422b0dd124f92022-12-22T01:14:04ZengBMCBMC Health Services Research1472-69632020-03-0120111310.1186/s12913-020-5002-4IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and useFiona Lobban0Duncan Appelbe1Victoria Appleton2Julie Billsborough3Naomi Ruth Fisher4Sheena Foster5Bethany Gill6David GlentworthChris HarropSonia Johnson7Steven H. Jones8Tibor Zoltan KovacsElizabeth Lewis9Barbara Mezes10Charlotte Morton11Elizabeth Murray12Puffin O’Hanlon13Vanessa Pinfold14Jo Rycroft-Malone15Ronald SiddleJo Smith16Chris J. Sutton17Pietro ViglienghiAndrew Walker18Division of Health Research, Lancaster UniversityClinical Trials Research Centre, University of LiverpoolDivision of Health Research, Lancaster UniversityMcPin FoundationDivision of Health Research, Lancaster UniversityMcPin FoundationDivision of Health Research, Lancaster UniversityDivision of Psychiatry, University College LondonDivision of Health Research, Lancaster UniversityDivision of Health Research, Lancaster UniversityDivision of Health Research, Lancaster UniversityDivision of Psychiatry, University College LondonResearch Department of Primary Care and Population Health, University College LondonDivision of Psychiatry, University College LondonMcPin FoundationFaculty of Health & Medicine, Lancaster UniversitySchool of Allied Health and Community, University of WorcesterCentre for Biostatistics, University of ManchesterDivision of Health Research, Lancaster UniversityAbstract Background Despite the potential of digital health interventions to improve the delivery of psychoeducation to people with mental health problems and their relatives, and substantial investment in their development, there is little evidence of successful implementation into clinical practice. We report the first implementation study of a digital health intervention: Relatives Education And Coping Toolkit (REACT), into routine mental healthcare. Our main aim was to identify critical factors affecting staff uptake and use of this online self-management tool for relatives of people with psychosis or bipolar. Methods A mixed-methods, theory-driven (Normalisation Process Theory), iterative multiple case study approach using qualitative analysis of interviews with staff and quantitative reporting of uptake. Carer researchers were part of the research team. Results In all, 281 staff and 159 relatives from Early Intervention teams across six catchment areas (cases) in England registered on REACT; 129 staff took part in qualitative interviews. Staff were positive about REACT helping services improve support and meet clinical targets. Implementation was hindered by: high staff caseloads and difficulties prioritising carers; perception of REACT implementation as research; technical difficulties using REACT; poor interoperability with trust computer systems and care pathways; lack of access to mobile technology and training; restricted forum populations; staff fears of risk, online trolling, and replacement by technology; and uncertainty around REACT’s long-term availability. Conclusions Digital health interventions, such as REACT, should be iteratively developed, evaluated, adapted and implemented, in partnership with the services they aim to support, and as part of a long term national strategy to co-develop integrated technology-enabled mental healthcare. Implementation strategies must instil a sense of ownership for staff and ensure they have adequate IT training, appropriate governance protocols for online working, and adequate mobile technologies. Wider contextual factors including adequate funding for mental health services and prioritisation of carer support, also need to be addressed for successful implementation of carer focussed digital interventions. Trial registration Study registration: ISCTRN 16267685 .http://link.springer.com/article/10.1186/s12913-020-5002-4Psychotic disordersCaregiversInternetImplementation scienceDigital health interventionMental health |
| spellingShingle | Fiona Lobban Duncan Appelbe Victoria Appleton Julie Billsborough Naomi Ruth Fisher Sheena Foster Bethany Gill David Glentworth Chris Harrop Sonia Johnson Steven H. Jones Tibor Zoltan Kovacs Elizabeth Lewis Barbara Mezes Charlotte Morton Elizabeth Murray Puffin O’Hanlon Vanessa Pinfold Jo Rycroft-Malone Ronald Siddle Jo Smith Chris J. Sutton Pietro Viglienghi Andrew Walker IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use BMC Health Services Research Psychotic disorders Caregivers Internet Implementation science Digital health intervention Mental health |
| title | IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use |
| title_full | IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use |
| title_fullStr | IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use |
| title_full_unstemmed | IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use |
| title_short | IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use |
| title_sort | implementation of an online relatives toolkit for psychosis or bipolar impart study iterative multiple case study to identify key factors impacting on staff uptake and use |
| topic | Psychotic disorders Caregivers Internet Implementation science Digital health intervention Mental health |
| url | http://link.springer.com/article/10.1186/s12913-020-5002-4 |
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