1. IMPlementation of A Relatives' Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol
- Author
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Elizabeth Murray, Andrew Walker, Jo Smith, Vanessa Pinfold, Puffin O’Hanlon, Johanna Barraclough, Duncan Appelbe, Chris J Sutton, Jo Rycroft-Malone, Steven Jones, Naomi Ruth Fisher, Elizabeth Lewis, Sheena Foster, Ron Siddle, Victoria Appleton, Sonia Johnson, Barbara Mezes, Fiona Lobban, Céu Mateus, and Julie Bowland
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Bipolar Disorder ,020205 medical informatics ,Psychological intervention ,BF ,B760 ,Health Informatics ,02 engineering and technology ,Health informatics ,State Medicine ,Health administration ,Study Protocol ,03 medical and health sciences ,0302 clinical medicine ,C848 ,Adaptation, Psychological ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Medicine ,Family ,030212 general & internal medicine ,Case series ,Health Education ,Health policy ,Patient Care Team ,Internet ,Medical education ,lcsh:R5-920 ,Self-management ,business.industry ,Self-Management ,Health Policy ,Early intervention services ,Public Health, Environmental and Occupational Health ,Health services research ,General Medicine ,Digital health ,United Kingdom ,Relatives ,Early intervention in psychosis ,Psychotic Disorders ,Research Design ,Implementation ,Bipolar ,Digital psychosis ,Mental health ,Web-based ,business ,lcsh:Medicine (General) ,Stress, Psychological - Abstract
Background: Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. Methods: A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives' Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives' distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Discussion: Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process under observation. We outline our strategies to ensure our design is transparent, flexible, and responsive to the timescales and activities happening within each service whilst also meeting the aims of the project. Trial registration: ISCTRN 16267685 (09/03/2016). © 2017 The Author(s).
- Published
- 2017
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