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IMPlementation of an online relatives’ toolkit for psychosis or bipolar (IMPARTstudy): iterative multiple case study to identify key factors impacting on staff uptake and use

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@article{2328abeeb38e42cdaf6e97a9b591f28f,
title = "IMPlementation of an online relatives{\textquoteright} toolkit for psychosis or bipolar (IMPARTstudy): 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 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{\textquoteright}s long-term availability.",
keywords = "Psychotic disorders, Caregivers, Internet, Implementation science, Digital health intervention, Mental health, Case series, Early intervention",
author = "Fiona Lobban and Steven Jones and Barbara Mezes and Jo Rycroft-Malone and Andrew Walker",
year = "2020",
month = feb
day = "14",
language = "English",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BMC",

}

RIS

TY - JOUR

T1 - IMPlementation of an online relatives’ toolkit for psychosis or bipolar (IMPARTstudy)

T2 - iterative multiple case study to identify key factors impacting on staff uptake and use

AU - Lobban, Fiona

AU - Jones, Steven

AU - Mezes, Barbara

AU - Rycroft-Malone, Jo

AU - Walker, Andrew

PY - 2020/2/14

Y1 - 2020/2/14

N2 - 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.

AB - 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.

KW - Psychotic disorders

KW - Caregivers

KW - Internet

KW - Implementation science

KW - Digital health intervention

KW - Mental health

KW - Case series

KW - Early intervention

M3 - Journal article

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

ER -