Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)
Por:
Mediavilla R, García-Vázquez B, McGreevy KR, Underhill J, Bayón C, Bravo-Ortiz MF, Muñoz-Sanjosé A, Haro JM, Monistrol A, Nicaise P, Petri-Romão P, David McDaid, Park AL, Melchior M, Vuillermoz C, Turrini G, Compri B, Purgato M, Roos R, Witteveen AB, Sijbrandij M, Bryant RA, Fuhr D and Ayuso-Mateos JL
Publicada:
1 ene 2024
Ahead of Print:
18 oct 2024
Resumen:
Objectives This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action.Methods We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo.Results Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components.Conclusions These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support.Trial registration number NCT04980326.
Filiaciones:
Mediavilla R:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain. RINGGOLD: 16517
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
García-Vázquez B:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain. RINGGOLD: 16268
Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. RINGGOLD: 638528
McGreevy KR:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Underhill J:
Research consultant, Brighton, UK
Bayón C:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain. RINGGOLD: 16268
Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. RINGGOLD: 638528
Bravo-Ortiz MF:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain. RINGGOLD: 16268
Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. RINGGOLD: 638528
Muñoz-Sanjosé A:
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain. RINGGOLD: 16268
Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. RINGGOLD: 638528
Haro JM:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Parc Sanitari Sant Joan de Deu, IRSJD, Sant Boi de Llobregat, Barcelona, Spain. RINGGOLD: 221703
Monistrol A:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Parc Sanitari Sant Joan de Deu, IRSJD, Sant Boi de Llobregat, Barcelona, Spain. RINGGOLD: 221703
Nicaise P:
Institute of Health and Society, UCLouvain, Belgium. RINGGOLD: 83415
Petri-Romão P:
Leibniz Institute for Resilience Research, Mainz, Germany. RINGGOLD: 539160
David McDaid:
Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK. RINGGOLD: 4905
Park AL:
Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK. RINGGOLD: 4905
Melchior M:
Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Paris, France. RINGGOLD: 27063
Vuillermoz C:
Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Paris, France. RINGGOLD: 27063
Turrini G:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy. RINGGOLD: 19051
Compri B:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy. RINGGOLD: 19051
Purgato M:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy. RINGGOLD: 19051
Roos R:
Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands. RINGGOLD: 1190
Witteveen AB:
Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands. RINGGOLD: 1190
Sijbrandij M:
Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands. RINGGOLD: 1190
Bryant RA:
School of Psychology, University of New South Wales, Sydney, Australia. RINGGOLD: 441985
Fuhr D:
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany. RINGGOLD: 39967
Health Sciences, University of Bremen, Bremen, Germany. RINGGOLD: 9168
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK. RINGGOLD: (4906
Ayuso-Mateos JL:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. RINGGOLD: 456032
Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain. RINGGOLD: 16517
Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain. RINGGOLD: 16722
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