Higgins, Agnes and Murphy, Rebecca and Downes, Carmel and Barry, Jennifer and Monahan, Mark and Hevey, David and Kroll, Thilo and Doyle, Louise and Gibbons, Patrick (2020) Factors impacting the implementation of a psychoeducation intervention within the mental health system: a multisite study using the consolidation framework for implementation research. BMC Health Services Research, 20 (1023). ISSN 1472-6963

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Abstract

Background: Despite a strong evidence base and policy recommendation supporting the implementation of psychoeducation interventions within the mental health system, equitable access for many service users and family members has not been achieved. To enhance translation, developing an evidence-base around the factors that influence implementation of interventions is critical. Methods: The aim of the study was to explore the factors influencing implementation of a group cofacilitated recovery focused psychoeducation intervention. The study design was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews with key stakeholders (n = 75) involved with the implementation within 14 mental health sites in the Republic of Ireland. The Consolidation Framework for Implementation Research (CFIR) was used as a conceptual framework to guide data collection and analysis. Results: Key enablers and barriers were identified across all CFIR domains of the framework with some factors (depending on context) being both an enabler and a barrier. Important factors in the outer setting domain included structural stability within national systems and the peer payment system, while the extent of a recovery�oriented culture, leadership, implementation readiness, and buy-in were influential factors in the inner setting. The characteristics of the intervention in terms of design, evidence-base and adaptability also shaped the intervention’s implementation as did the knowledge, beliefs and self-efficacy of facilitators. In terms of processes, implementation was influenced by the degree of engagement of key individuals who championed and supported the programme. The results highlight that while some of the barriers were specific to the programme, many reflected systemic and structural challenges within health services more generally. Conclusion: Findings from this study provide an enhanced understanding of the different layers of determinants to implementation of an intervention. Overcoming challenges will involve positive and ongoing engagement and collaboration across the full range of stakeholders that are active within each domain, including policy and operational levels. The quality of leadership at each domain level is of crucial importance to successful implementation. Keywords: Implementation science, Barriers, Enablers, Psychoeducation, Mental health services, Framework analysis, Consolidation framework for implementation research

Item Type:	Article
Additional Information:	The paper was funded by a grant from the Health Research Board Ireland in partnership with the Health Service Executive through the Applied Partnership Award scheme [Grant number APA-206-1858]. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Cite as: Higgins, A., Murphy, R., Downes, C. et al. Factors impacting the implementation of a psychoeducation intervention within the mental health system: a multisite study using the consolidation framework for implementation research. BMC Health Serv Res 20, 1023 (2020). https://doi.org/10.1186/s12913-020-05852-9.
Keywords:	Implementation science; Barriers; Enablers; Psychoeducation, Mental health services; Framework analysis; Consolidation framework for implementation research;
Academic Unit:	Faculty of Science and Engineering > Psychology
Item ID:	15082
Identification Number:	https://doi.org/10.1186/s12913-020-05852-9
Depositing User:	Rebecca Murphy
Date Deposited:	01 Dec 2021 16:30
Journal or Publication Title:	BMC Health Services Research
Publisher:	BioMed Central
Refereed:	Yes
Funders:	Health Research Board (HRB), Health Service Executive (HSE)
URI:	Publisher
Use Licence:	This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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