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    Rights statement: This is the author’s version of a work that was accepted for publication in The Lancet Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Lancet Psychiatry, ?, ?, 2018 DOI: 10.1016/S2215-0366

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Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

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E-pub ahead of print
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<mark>Journal publication date</mark>3/12/2018
<mark>Journal</mark>Lancet Psychiatry
Publication StatusE-pub ahead of print
Early online date3/12/18
<mark>Original language</mark>English

Abstract

Summary
Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.