Stakeholder Perspectives on Implementation of Internet-delivered Cognitive Behaviour Therapy in Physical Medicine Rehabilitation Setting Using the Consolidated Framework for Implementation Research

Overview

Journal J Rehabil Med

Date 2025 Jan 15

PMID 39810475

Authors

Swati Mehta

Ujjoyinee Barua

Marcie Nugent

Kevin Hansen

Luvish Sondhi

Randy Upper

Dalton Wolfe

Eldon Roh

Keith Sequeira

Robert Teasell

Heather D Hadjistavropoulos

Affiliations

Soon will be listed here.

Abstract

Introduction: Despite the growing evidence for the effects of tailored internet-delivered cognitive behaviour therapy (ICBT) programmes for those receiving physical rehabilitation, there is a lack of implementation of these programmes in a clinical or community setting. The aim of the current study was to evaluate barriers and facilitators of implementing an ICBT programme into a physical medicine rehabilitation setting.

Methods: Stakeholders with expertise in physical medicine rehabilitation were recruited (n = 25) including: 16 clinicians, 4 administrators, 3 persons with lived experience, and 2 care partners. Individual semi-structured interviews were conducted based on the domains of the Consolidated Framework for Implementation Research (CFIR). Transcripts were analysed using a positivist approach, using deductive thematic content analysis. Themes were coded based on the domains of CFIR.

Results: Facilitators for implementation primarily fell under intervention characteristics including relative advantage, strong evidence and quality, and design quality. Perceived barriers for implementation were identified in the inner setting including leadership engagement, culture, and available resources.

Conclusions: The results from the current study provide insight on the factors that may contribute towards successful implementation of an ICBT programme in a physical medicine setting.

References

Harst L, Lantzsch H, Scheibe M . Theories Predicting End-User Acceptance of Telemedicine Use: Systematic Review. J Med Internet Res. 2019; 21(5):e13117. PMC: 6547771. DOI: 10.2196/13117. View

Shek A, Biondi A, Ballard D, Wykes T, Simblett S . Technology-based interventions for mental health support after stroke: A systematic review of their acceptability and feasibility. Neuropsychol Rehabil. 2019; 31(3):432-452. DOI: 10.1080/09602011.2019.1701501. View

Chirinos D, Vargas E, Kamsickas L, Carnethon M . The role of behavioral science in addressing cardiovascular health disparities: A narrative review of efforts, challenges, and future directions. Health Psychol. 2022; 41(10):740-754. PMC: 9886136. DOI: 10.1037/hea0001191. View

Nilsen P . Making sense of implementation theories, models and frameworks. Implement Sci. 2015; 10:53. PMC: 4406164. DOI: 10.1186/s13012-015-0242-0. View

Damschroder L, Hagedorn H . A guiding framework and approach for implementation research in substance use disorders treatment. Psychol Addict Behav. 2011; 25(2):194-205. DOI: 10.1037/a0022284. View

Webb C, Rosso I, Rauch S . Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions. Harv Rev Psychiatry. 2017; 25(3):114-122. PMC: 5421393. DOI: 10.1097/HRP.0000000000000139. View

Kadesjo Banck J, Bernhardsson S . Experiences from implementation of internet-delivered cognitive behaviour therapy for insomnia in psychiatric health care: a qualitative study applying the NASSS framework. BMC Health Serv Res. 2020; 20(1):729. PMC: 7414663. DOI: 10.1186/s12913-020-05596-6. View

Alberts N, Hadjistavropoulos H, Dear B, Titov N . Internet-delivered cognitive-behaviour therapy for recent cancer survivors: a feasibility trial. Psychooncology. 2015; 26(1):137-139. DOI: 10.1002/pon.4032. View

Al-Saleh S, Lee J, Rogers W, Insel K . Translation of a Successful Behavioral Intervention to a Digital Therapeutic Self-Management System for Older Adults. Ergon Des. 2024; 32(2):5-13. PMC: 10936698. DOI: 10.1177/10648046211066409. View

10.

Fowe I . Evaluating Organizational Readiness for Change in the Implementation of Telehealth and mobile Health Interventions for Chronic Disease Management. AMIA Jt Summits Transl Sci Proc. 2021; 2021:210-219. PMC: 8378641. View

11.

Titzler I, Saruhanjan K, Berking M, Riper H, Ebert D . Barriers and facilitators for the implementation of blended psychotherapy for depression: A qualitative pilot study of therapists' perspective. Internet Interv. 2018; 12:150-164. PMC: 6096333. DOI: 10.1016/j.invent.2018.01.002. View

12.

Krause J, Kemp B, Coker J . Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators. Arch Phys Med Rehabil. 2000; 81(8):1099-109. DOI: 10.1053/apmr.2000.7167. View

13.

Sandstrom B, Borglin G, Nilsson R, Willman A . Promoting the implementation of evidence-based practice: a literature review focusing on the role of nursing leadership. Worldviews Evid Based Nurs. 2011; 8(4):212-23. DOI: 10.1111/j.1741-6787.2011.00216.x. View

14.

Dirkse D, Hadjistavropoulos H, Alberts N, Karin E, Schneider L, Titov N . Making Internet-delivered cognitive behaviour therapy scalable for cancer survivors: a randomized non-inferiority trial of self-guided and technician-guided therapy. J Cancer Surviv. 2019; 14(2):211-225. DOI: 10.1007/s11764-019-00810-9. View

15.

Dear B, Nicholson Perry K, Siddall P, Middleton J, Johnson J, Katte L . The Pain Course: exploring the feasibility of an internet-delivered pain management programme for adults with spinal cord injury. Spinal Cord. 2018; 56(10):931-939. DOI: 10.1038/s41393-018-0146-3. View

15.

Kontos P, Poland B . Mapping new theoretical and methodological terrain for knowledge translation: contributions from critical realism and the arts. Implement Sci. 2009; 4:1. PMC: 2639531. DOI: 10.1186/1748-5908-4-1. View

16.

Tolin D . Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clin Psychol Rev. 2010; 30(6):710-20. DOI: 10.1016/j.cpr.2010.05.003. View

17.

Balas M, Burke W, Gannon D, Cohen M, Colburn L, Bevil C . Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium.... Crit Care Med. 2013; 41(9 Suppl 1):S116-27. PMC: 4096994. DOI: 10.1097/CCM.0b013e3182a17064. View

18.

Varsi C, Ekstedt M, Gammon D, Ruland C . Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study. J Med Internet Res. 2015; 17(11):e262. PMC: 4704938. DOI: 10.2196/jmir.5091. View

19.

Robins L, Jackson J, Green B, Korngiebel D, Force R, Baldwin L . Barriers and facilitators to evidence-based blood pressure control in community practice. J Am Board Fam Med. 2013; 26(5):539-57. PMC: 3882900. DOI: 10.3122/jabfm.2013.05.130060. View