Barriers and facilitators to the integration of digital technologies in mental health systems: A protocol for a qualitative systematic review

Berardi, Chiara; Hinwood, Madeleine; Smith, Angela; Melia, Adrian; Paolucci, Francesco

doi:10.1371/journal.pone.0259995

Cited by 5 publications

(9 citation statements)

References 60 publications

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“…Eligible studies will be reports of original research, peer-reviewed articles with a qualitative component pertaining to barriers and facilitators of digital interventions for loneliness among older adults, including, but not limited to, designs such as ethnography, action research, case studies, implementation studies, qualitative process evaluation and qualitative interviews with stakeholders 71 86…”

Section: Methods and Analysismentioning

confidence: 99%

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

Zhang

Välimäki

et al. 2022

BMJ Open

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IntroductionDigital interventions are considered as a potential solution to loneliness in older adults. However, this type of intervention has had limited acceptance among older adults (aged ≥60 years). To ensure the use of digital interventions in older adults, possible barriers and facilitating factors should be better understood from the user’s perspective. We aim to systematically examine the barriers and facilitators to the implementation of digital interventions designed to reduce loneliness in older adults by identifying, evaluating and synthesising qualitative studies.Methods and analysisA comprehensive search of qualitative studies for barriers and facilitators for use of digital interventions will be conducted in the following databases: PubMed, MEDLINE, CINAHL, Embase, Scopus, Cochrane Library and Web of Science. Studies reported in English will be considered for this review. Grey literature will not be included. Two reviewers (HZ and XL) will independently screen the literatures, and any differences will be solved by turning to the third reviewer (JN). The Joanna Briggs Institute (JBI) Qualitative Research Critical Appraisal Checklist will be used by two reviewers to independently assess the validity of the methods used. Relevant data about the populations, context, culture, geographical location, study methods and barriers and facilitators to the implementation of digital interventions will be extracted using the JBI standardised data extraction tool. JBI meta-aggregation methods will be implemented to synthesise the data, which will generate themes and categories based on the data. The final synthesis will establish confidence levels using the JBI ConQual approach.Ethics and disseminationThe protocol does not require ethical approval. The data are based on published scientific databases. The results will be disseminated through journal articles and scientific conference presentations (if feasible).PROSPERO registration numberCRD42022328609.

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Section: Methods and Analysismentioning

confidence: 99%

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

Zhang

Välimäki

et al. 2022

BMJ Open

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“…Therefore, how we ensure that digital tools are successfully implemented in therapy and in the management of mental health problems remains crucial. As many authors and mental health professionals have communicated, to enhance uptake of digital mental health care and deliver digitally enabled care as envisaged, there is a need for practical solutions (e.g., Berardi et al, 2021; Mohr et al, 2021). This is where digital inclusion initiatives come into play.…”

Section: Introductionmentioning

confidence: 99%

A call for digital inclusion initiatives in mental health services: An integrative review

Petrou

Jameel

Nahabedian

et al. 2023

Psychiatric Ment Health Nurs

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Accessible SummaryWhat is Known on the Subject? Digital tools such as video calls or mobile phone applications (apps) are increasingly used in the provision of mental healthcare. There is evidence that people with mental health problems are more likely to face digital exclusion: that is, they do not have access to devices and/or skills to use technology. This leaves some people unable to use digital mental health services (e.g., apps or online appointments) or to benefit more generally from access to the digital world (e.g., online shopping or connecting with others virtually). People can be digitally included through initiatives that provide devices, Internet and digital mentoring to increase knowledge and confidence when using technology. What the Paper Adds to Existing Knowledge? Some initiatives in academic studies and grey literature have been shown to increase access to and knowledge of technology, but this has been outside of mental health care settings. There are currently limited digital inclusion initiatives that take into consideration the specific needs of people with mental health problems, and how they can be equipped and familiarised with digital technologies to help their recovery journey and everyday life activities. What are the Implications for Practice? Further work is needed to improve the provision of digital tools in mental health care, with more practical digital inclusion initiatives to ensure equal access for all. If digital exclusion is not addressed, the gap between people with and those without digital skills or access to technology will continue to grow, enlarging mental health inequalities. AbstractIntroductionThe rise in the provision of digital healthcare during the pandemic has called attention to digital exclusion: inequality in access and/or capacity to use digital technologies. Digital exclusion is more profound in people with mental health problems, leaving an implementation gap of digital practice in mental health services.AimIdentify the available evidence of (a) addressing digital exclusion in mental health care and (b) the practical solutions to enhance uptake of digital mental health.MethodDigital inclusion initiatives were searched from both academic and grey literature available and published between the years 2007 and 2021.ResultsA limited number of academic studies and initiatives were found that supported people with mental health difficulties who had limited skills and/or access to overcome digital exclusion.DiscussionFurther work is needed to combat digital exclusion and establish ways to reduce the implementation gap in mental health services.Implications for PracticeAccess to devices, Internet connectivity and digital mentoring for mental health service users is essential. More studies and programmes are needed to disseminate impact and results for digital inclusion initiatives for people with mental health problems and to inform best practice for digital inclusion within mental health services.

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“…including patient preferences, healthcare provider attitudes, organizational support, and technological constraints. [19][20][21] However, there remains a need for more nuanced insights into the behavioral in uences that shape the adoption of digital tools in clinical settings. For example, it is currently unknown how attitudes, knowledge, and the system in which clinicians practice interact to in uence behavior.…”

mentioning

confidence: 99%

“…[16] Additionally, there is currently a lack of research on barriers and facilitators to implementing digital tools for speci c psychiatric concerns, such as SRTB, particularly in acute care settings, such as the ED. [19,21] Additionally, in a synthesis of 81 qualitative research evidence on barriers to adopting digital technologies in mental health systems, only nine were from Canada, and none of these Canadian studies examined implementation determinants for apps. [19] To address this gap, the present study aims to identify barriers and facilitators for adopting a SPI app using behaviour change frameworks.…”

mentioning

confidence: 99%

“…[19,21] Additionally, in a synthesis of 81 qualitative research evidence on barriers to adopting digital technologies in mental health systems, only nine were from Canada, and none of these Canadian studies examined implementation determinants for apps. [19] To address this gap, the present study aims to identify barriers and facilitators for adopting a SPI app using behaviour change frameworks.…”

mentioning

confidence: 99%

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Barriers and Facilitators to Using an App-Based Tool for Suicide Safety Planning in a Psychiatric Emergency Department: A Qualitative Descriptive Study Using the Theoretical Domains Framework and COM-B Model

Shin,

Durocher,

Kassam

et al. 2024

Preprint

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Background Emergency departments (ED) play a crucial role in suicide prevention, with evidenced-based safety planning interventions (SPI) playing an important role. Traditional safety plans, which are often paper based, come with challenges (i.e., not easily accessible, or easy to misplace). Digital safety planning tools offer an alternative mode of intervention delivery, but clinical implementation remains limited. Using behavioural change frameworks, we aim to provide insights into the factors influencing app adoption. These insights will be used as a knowledge base to design behavior change strategies to promote the implementation of a SPI app in a psychiatric ED. Methods We used a qualitative descriptive design to conduct semi-structured interviews with clinicians in a psychiatric ED in Toronto, Canada. Participants encompassed all ED staff, irrespective of their SPI app usage. The semi-structured interview guide was developed using the Theoretical Domains Framework (TDF) and the capability (C), opportunity (O), motivation (M) and behavior (B) (COM-B) model. We then used directed content analysis, identifying findings within the TDF and COM-B domains as barriers, facilitators, or both. Findings: A total of 29 ED clinicians were interviewed, including nurses, psychiatrists, social workers, program assistants, and a pharmacist. The majority had not used the app. We observed strong motivation among clinicians across all disciplines to use the app, and they considered SPI as a high-priority ED care strategy closely linked to their professional identity and responsibility. Anticipated barriers regarding the app as a new mode of SPI delivery in routine practice included: documentation, communication, care efficiency, and patient access to smartphones. Some barriers were attributable to the lack of interoperability between the app and the electronic health record and documentation infrastructure for the app. Conclusion We identified key behavioral factors influencing the implementation of the SPI app in the psychiatric ED. We found that tailored strategies are essential to address barriers, while leveraging facilitators can sustain implementation. Additionally, ongoing monitoring and adaptation of strategies are necessary, as new barriers may arise or facilitators may weaken over time, impacting the sustained use of the app in the ED. We will use these findings to inform the next phase of this work, which involves co-designing targeted and tailored implementation strategies.

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Barriers and facilitators to the integration of digital technologies in mental health systems: A protocol for a qualitative systematic review

Cited by 5 publications

References 60 publications

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

Barriers and facilitators of digital interventions use to reduce loneliness among older adults: a protocol for a qualitative systematic review

A call for digital inclusion initiatives in mental health services: An integrative review

Barriers and Facilitators to Using an App-Based Tool for Suicide Safety Planning in a Psychiatric Emergency Department: A Qualitative Descriptive Study Using the Theoretical Domains Framework and COM-B Model

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