Potential Implementers' Perspectives on the Development and Implementation of an E-Mental Health Intervention for Caregivers of Adults With Chronic Kidney Disease: Qualitative Interview Study

Overview

Journal JMIR Hum Factors

Specialty Health Services

Date 2023 Oct 4

PMID 37792676

Authors

Chelsea Coumoundouros

Rabie Adel El Arab

Paul Farrand

Alexander Hamilton

Robbert Sanderman

Louise von Essen

Joanne Woodford

Affiliations

Soon will be listed here.

Abstract

Background: e-Mental health interventions can improve access to mental health support for caregivers of people living with chronic kidney disease (CKD). However, implementation challenges often prevent effective interventions from being put into practice. To develop an e-mental health intervention for caregivers of people living with CKD that is optimized for future implementation, it is important to engage professionals that may endorse or deliver the intervention (ie, potential implementers) during intervention development.

Objective: This study aims to explore the perspectives of potential implementers working in kidney care, in mental health care, or at nonprofit organizations regarding the design and implementation of an e-mental health intervention for caregivers of people living with CKD.

Methods: Potential implementers (N=18) were recruited via National Health Service Trusts, email, and social media advertisements to participate in semistructured video interviews. Interview questions were informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive analysis approach using the CFIR, with inductive coding applied to relevant data not captured by the framework.

Results: A total of 29 generic categories, related to 17 CFIR constructs, were identified. The perceived fit between the intervention and implementation context (ie, existing service delivery models and work routines) and existing social networks among potential implementers were perceived as important factors in enhancing implementation potential. However, a need for capacity building among potential implementers to create systems to support the identification and referral of caregivers to an e-mental health intervention was identified. Equity concerns were raised regarding the intervention, highlighting the importance of incorporating an equity lens during intervention design to enhance accessibility and adoption.

Conclusions: Potential implementers provided valuable insights into key design and implementation factors to help inform the development of an e-mental health intervention for caregivers of people living with CKD. Incorporating their feedback can help ensure the intervention is acceptable and inform the selection of future implementation strategies to enhance the implementation potential of the intervention. Potential implementers should continue to be engaged throughout intervention development.

Citing Articles

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PMID: 39421310 PMC: 11483713. DOI: 10.1177/20552076241289179.

"Systems seem to get in the way": a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease.

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References

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

Krefting L . Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991; 45(3):214-22. DOI: 10.5014/ajot.45.3.214. View

Griffin J, Riffin C, Bangerter L, Schaepe K, Havyer R . Provider perspectives on integrating family caregivers into patient care encounters. Health Serv Res. 2021; 57(4):892-904. PMC: 9264458. DOI: 10.1111/1475-6773.13932. View

Wakefield S, Kellett S, Simmonds-Buckley M, Stockton D, Bradbury A, Delgadillo J . Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta-analysis of 10-years of practice-based evidence. Br J Clin Psychol. 2020; 60(1):1-37. DOI: 10.1111/bjc.12259. View

Mosher C, Champion V, Hanna N, Jalal S, Fakiris A, Birdas T . Support service use and interest in support services among distressed family caregivers of lung cancer patients. Psychooncology. 2012; 22(7):1549-56. PMC: 3535684. DOI: 10.1002/pon.3168. View

Karyotaki E, Efthimiou O, Miguel C, Maas Genannt Bermpohl F, Furukawa T, Cuijpers P . Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis. JAMA Psychiatry. 2021; 78(4):361-371. PMC: 8027916. DOI: 10.1001/jamapsychiatry.2020.4364. View

Dionne-Odom J, Applebaum A, Ornstein K, Azuero A, Warren P, Taylor R . Participation and interest in support services among family caregivers of older adults with cancer. Psychooncology. 2017; 27(3):969-976. PMC: 5840039. DOI: 10.1002/pon.4603. View

Adejumo O, Iyawe I, Akinbodewa A, Abolarin O, Alli E . Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients. Ghana Med J. 2019; 53(3):190-196. PMC: 6842729. DOI: 10.4314/gmj.v53i3.2. View

Coumoundouros C, Farrand P, Hamilton A, von Essen L, Sanderman R, Woodford J . Cognitive behavioural therapy self-help intervention preferences among informal caregivers of adults with chronic kidney disease: an online cross-sectional survey. BMC Nephrol. 2023; 24(1):4. PMC: 9812545. DOI: 10.1186/s12882-022-03052-7. View

10.

Mummah S, Robinson T, King A, Gardner C, Sutton S . IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior. J Med Internet Res. 2016; 18(12):e317. PMC: 5203679. DOI: 10.2196/jmir.5927. View

11.

Matthews M, Reid J, McKeaveney C, Mullan R, Bolton S, Hill C . Development of a psychosocial intervention to support informal caregivers of people with end-stage kidney disease receiving haemodialysis. BMC Nephrol. 2020; 21(1):421. PMC: 7527291. DOI: 10.1186/s12882-020-02075-2. View

12.

Williams E, Morrow S . Achieving trustworthiness in qualitative research: a pan-paradigmatic perspective. Psychother Res. 2009; 19(4-5):576-82. DOI: 10.1080/10503300802702113. View

13.

Coumoundouros C, Martensson E, Ferraris G, Zuidberg J, von Essen L, Sanderman R . Implementation of e-Mental Health Interventions for Informal Caregivers of Adults With Chronic Diseases: Mixed Methods Systematic Review With a Qualitative Comparative Analysis and Thematic Synthesis. JMIR Ment Health. 2022; 9(11):e41891. PMC: 9752475. DOI: 10.2196/41891. View

14.

Shelton R, Lee M, Brotzman L, Crookes D, Jandorf L, Erwin D . Use of social network analysis in the development, dissemination, implementation, and sustainability of health behavior interventions for adults: A systematic review. Soc Sci Med. 2018; 220:81-101. PMC: 7857673. DOI: 10.1016/j.socscimed.2018.10.013. View

15.

Peters M, Rand S, Fitzpatrick R . Enhancing primary care support for informal carers: A scoping study with professional stakeholders. Health Soc Care Community. 2019; 28(2):642-650. PMC: 7027470. DOI: 10.1111/hsc.12898. View

16.

Marques M, Wright A, Corker E, Johnston M, West R, Hastings J . The Behaviour Change Technique Ontology: Transforming the Behaviour Change Technique Taxonomy v1. Wellcome Open Res. 2023; 8:308. PMC: 10427801. DOI: 10.12688/wellcomeopenres.19363.1. View

17.

Mosher C, Given B, Ostroff J . Barriers to mental health service use among distressed family caregivers of lung cancer patients. Eur J Cancer Care (Engl). 2014; 24(1):50-9. PMC: 4209195. DOI: 10.1111/ecc.12203. View

18.

Fridberg H, Wallin L, Tistad M . [The innovation characteristics of person-centred care as perceived by healthcare professionals: an interview study employing a deductive-inductive content analysis guided by the consolidated framework for implementation research. BMC Health Serv Res. 2021; 21(1):904. PMC: 8414852. DOI: 10.1186/s12913-021-06942-y. View

19.

Alshammari B, Noble H, McAneney H, Alshammari F, OHalloran P . Factors Associated with Burden in Caregivers of Patients with End-Stage Kidney Disease (A Systematic Review). Healthcare (Basel). 2021; 9(9). PMC: 8468425. DOI: 10.3390/healthcare9091212. View

20.

Waltz T, Powell B, Fernandez M, Abadie B, Damschroder L . Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Implement Sci. 2019; 14(1):42. PMC: 6489173. DOI: 10.1186/s13012-019-0892-4. View