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Dar A, Budgett J, Zabihi S, Whitfield E, Lang I, Rapaport P, Heath B, Ogden M, Phillips R, Burton A, Butler L, Wyman D, Hoe J, Manthorpe J, Morgan-Trimmer S, Koutsoubelis F, Cooper C. Pre-implementation planning for a new personalised, dementia post-diagnostic support intervention: exploring the perspective of professional stakeholders. BJPsych Open 2024; 10:e139. [PMID: 39103976 DOI: 10.1192/bjo.2024.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Only a third of people with dementia receive a diagnosis and post-diagnostic support. An eight session, manualised, modular post-diagnostic support system (New Interventions for Independence in Dementia Study (NIDUS) - family), delivered remotely by non-clinical facilitators is the first scalable intervention to improve personalised goal attainment for people with dementia. It could significantly improve care quality. AIMS We aimed to explore system readiness for NIDUS-family, a scalable, personalised post-diagnostic support intervention. METHOD We conducted semi-structured interviews with professionals from dementia care services; the Consolidated Framework for Implementation Research guided interviews and their thematic analysis. RESULTS From 2022 to 2023, we interviewed a purposive sample of 21 professionals from seven English National Health Service, health and social care services. We identified three themes: (1) potential value of a personalised intervention - interviewees perceived the capacity for choice and supporting person-centred care as relative advantages over existing resources; (2) compatibility and deliverability with existing systems - the NIDUS-family intervention model was perceived as compatible with service goals and clients' needs, but current service infrastructures, financing and commissioning briefs constraining resources to those at greatest need were seen as barriers to providing universal, post-diagnostic care; (3) fit with current workforce skills - the intervention model aligned well with staff development plans; delivery by non-clinically qualified staff was considered an advantage over current care options. CONCLUSIONS Translating evidence for scalable and effective post-diagnostic care into practice will support national policies to widen access to support and upskill support workers, but requires a greater focus on prevention in commissioning briefs and resource planning.
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Affiliation(s)
- Ayesha Dar
- Division of Psychiatry, University College London, London, UK
| | - Jessica Budgett
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Sedigheh Zabihi
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Ellenyd Whitfield
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | | | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | | | | | | | | | | | | | | | - Jill Manthorpe
- The Policy Institute at King's, King's College London, London, UK
| | | | | | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University London, London, UK
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Bhardwaj A, FitzGerald C, Graham M, MacFarlane A, Kennedy N, Toomey CM. Barriers and facilitators to implementation of an exercise and education programme for osteoarthritis: a qualitative study using the consolidated framework for implementation research. Rheumatol Int 2024; 44:1035-1050. [PMID: 38649534 PMCID: PMC11108926 DOI: 10.1007/s00296-024-05590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
Targeted efforts to better understand the barriers and facilitators of stakeholders and healthcare settings to implementation of exercise and education self-management programmes for osteoarthritis (OA) are needed. This study aimed to explore the barriers and facilitators to the implementation of Good Life with osteoArthritis in Denmark (GLA:D), a supervised group guideline-based OA programme, across Irish public and private healthcare settings. Interviews with 10 physiotherapists (PTs; 8 public) and 9 people with hip and knee OA (PwOA; 4 public) were coded by the Consolidated Framework for Implementation Research (CFIR) constructs in a case memo (summary, rationale, quotes). The strong positive/negative implementation determinants were identified collaboratively by rating the valence and strength of CFIR constructs on implementation. Across public and private settings, PTs and PwOA strongly perceived GLA:D Ireland as evidence-based, with easily accessible education and modifiable marketing/training materials that meet participants' needs, improve skills/confidence and address exercise beliefs/expectations. Despite difficulties in scheduling sessions (e.g., work/caring responsibilities), PTs in public and private settings perceived advantages to implementation over current clinical practice (e.g., shortens waiting lists). Only PTs in public settings reported limited availability of internal/external funding, inappropriate space, marketing/training tools, and inadequate staffing. Across public and private settings, PwOA reported adaptability, appropriate space/equipment and coaching/supervision, autonomy, and social support as facilitators. Flexible training and tailored education for stakeholders and healthcare settings on guideline-based OA management may promote implementation. Additional support on organising (e.g., scheduling clinical time), planning (e.g., securing appropriate space, marketing/training tools), and funding (e.g., accessing dedicated internal/external grants) may strengthen implementation across public settings.
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Affiliation(s)
- Avantika Bhardwaj
- School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland.
- Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Christine FitzGerald
- School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland
- Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Margaret Graham
- Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
- Department of Nursing & Midwifery, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Anne MacFarlane
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- Participatory Health Research Unit, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Norelee Kennedy
- School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland
- Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Clodagh M Toomey
- School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland
- Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
- Participatory Health Research Unit, University of Limerick, Limerick, V94 T9PX, Ireland
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Van Hoye A, Regan C, Lane A, Vuillemin A, Woods C. Implementation of the GAA 'healthy clubs project' in Ireland: a qualitative study using the Consolidated Framework for Implementation Research. Health Promot Int 2024; 39:daad191. [PMID: 38243778 PMCID: PMC10799314 DOI: 10.1093/heapro/daad191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Abstract
The sports clubs' role in promoting health has been acknowledged by policy makers and researchers, but there is little evidence on how sports clubs implement health-related interventions. The present article investigates the Gaelic Athletic Association Healthy Club Project (HCP) implementation process (mechanisms, barriers, leverages) over a 10-year timeframe. A case study design helped to produce and compare a data synthesis for five clubs involved since 2013. A qualitative iterative data collection, including document analysis was conducted through 20 focus groups with Healthy Club Officers, coaches, participants and members. The Consolidated Framework for Implementation Research was used in the deductive analysis process, conducted by the first author. Results have shown the success of the HCP in placing health promotion on the agenda of sports clubs leading to informal policy for health promotion, even if activities and recognition are directed toward and coming from the community. This study also underlines the virtuous cycle of the settings-based approach in enhancing membership and volunteer recognition through health promotion actions, and the importance of social good and corporate social activities for sports clubs. Nevertheless, the HCP still relies on limited human resources, is not recognized by competitive oriented adult playing members. and acknowledged as a resource by some coaches, limiting its rootedness in the core business of sports clubs. Future research should empower the HCP community to focus on organizational changes and develop outcomes for individuals, for the club as a whole as well as for the local community.
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Affiliation(s)
- A Van Hoye
- Physical Activity for Health Research Centre, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, V94T9PX Limerick, Ireland
- UMR 1319 INSPIIRE, Université de Lorraine, 54600 Vandoeuvre-les-Nancy, France
| | - C Regan
- Community and Health Department, Gaelic Athletic Association, D03 P6K7 Dublin, Ireland
| | - A Lane
- SHE Research Group, Technological University of the Shannon, N37HD68 Athlone, Ireland
| | - A Vuillemin
- LAHMESS, Université Côte d’Azur, 06200 Nice, France
| | - C Woods
- Physical Activity for Health Research Centre, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, V94T9PX Limerick, Ireland
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