Evidence map›Paper›PMID 32183787›Full record

ArticleBMC health services research2020

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.

Fiona Lobban, Duncan Appelbe, Victoria Appleton, Julie Billsborough, Naomi Ruth Fisher, Sheena Foster, Bethany Gill, David Glentworth, Chris Harrop, Sonia Johnson and 14 more

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Participatory research with carers: A systematic review and narrative synthesis.Health expectations : an international journal of public participation in health care and health policy · 2024
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 7 institutions in 1 country.

Fiona LobbanDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK. f.lobban@lancaster.ac.uk.ORCID http://orcid.org/0000-0001-6594-4350
Duncan AppelbeClinical Trials Research Centre, University of Liverpool, Liverpool, UK.
Victoria AppletonDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Julie BillsboroughMcPin Foundation, London, UK.
Naomi Ruth FisherDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Sheena FosterMcPin Foundation, London, UK.
Bethany GillDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
David Glentworth, participating NHS trust, England.
Chris Harrop, participating NHS trust, England.
Sonia JohnsonDivision of Psychiatry, University College London, London, UK.
Steven H JonesDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Tibor Zoltan Kovacs, participating NHS trust, England.
Elizabeth LewisDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Barbara MezesDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Charlotte MortonDivision of Psychiatry, University College London, London, UK.
Elizabeth MurrayResearch Department of Primary Care and Population Health, University College London, London, UK.
Puffin O'HanlonDivision of Psychiatry, University College London, London, UK.
Vanessa PinfoldMcPin Foundation, London, UK.
Jo Rycroft-MaloneFaculty of Health & Medicine, Lancaster University, Lancaster, England.
Ronald Siddle, participating NHS trust, England.
Jo SmithSchool of Allied Health and Community, University of Worcester, Worcester, UK.
Chris J SuttonCentre for Biostatistics, University of Manchester, Manchester, England.
Pietro Viglienghi, participating NHS trust, England.
Andrew WalkerDivision of Health Research, Lancaster University, Bailrigg Campus, Lancaster, LA1 4YW, UK.
Lancaster University · GBOxleas NHS Foundation Trust · GBUniversity College London · GBMcPin Foundation · GBUniversity of Liverpool · GBUniversity of Manchester · GBUniversity of Worcester · GB

Funding

Department of Health 14/04/16National Institute for Health Research 14/04/16
6 · The paper itself

Abstract

backgroundDespite 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.

methodsA 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.

resultsIn 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.

conclusionsDigital 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 registrationStudy registration: ISCTRN 16267685.

Indexed as

Attitude of Health PersonnelCaregiversComputer-Assisted InstructionEducation, DistanceMental Health ServicesAdaptation, PsychologicalAttitude to ComputersBipolar DisorderEnglandFamilyHealth EducationHumansInternetPsychotic DisordersSelf-ManagementCaregiversCase seriesDigital health interventionEarly interventionImplementation scienceInternetMental healthPsychotic disorders

Identifiers

PMID32183787
PMCPMC7077000
OpenAlexW3011860995

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.