Evaluation of the implementation of an internet intervention in well-baby clinics: A pilot study

Abstract

PurposeDespite promising results, internet interventions are not widely accessible or well-integrated in health services. The objective of this study was, therefore, to examine the implementation of an internet intervention (‘Mamma Mia’) for the prevention of perinatal depression in Norwegian well-baby clinics (i.e., primary care).MethodsMamma Mia begins in mid-pregnancy and lasts up to 6 months after childbirth. It consists of 44 online sessions, supported by midwives and public health nurses at up to 5 contact points during this period, following principles of empathic communication. Well-baby clinics offer free, universal services to all pregnant women and children aged 0 to 5 years in Norway and were recruited via an intermediary organization for this study. Data were collected at pre- and post-training, but before the delivery of Mamma Mia in clinics, and at 3 and 6 months follow-up. Quantitative and qualitative data were used to evaluate the training in Mamma Mia, examine program implementation (i.e., number of pregnant women registered for the program), and identify barriers and enablers of implementation.ResultsTwenty-four self-selected healthcare professionals from 14 well-baby clinics were recruited, for this study. Training increased participants' knowledge about Mamma Mia and exceeded their expectations. The program review and implementation plan were necessary training components. Implementation climate was related to the number of colleagues working with Mamma Mia and overall satisfaction with implementation, while characteristics of the intervention predicted the number of registered women at 6 months. Organizational re-structuring, leadership, and competing activities were identified as barriers to implementation that need to be considered further.ConclusionsThe dissemination and implementation of a health-service supported internet intervention appears to be promising but requires further research.

Health Personnel’s Perceived Usefulness of Internet-Based Interventions for Parents of Children Younger Than 5 Years: Cross-Sectional Web-Based Survey Study

“…However, child and youth mental health workers seem cautiously positive [ 23 , 24 ], particularly in the prevention and treatment of mild-to-moderate mental health problems [ 24 , 25 ]. Furthermore, previous research has shown that leadership and different leadership styles may also have an impact on the adoption and perceived usefulness of technology [ 26 , 27 ]. Thus, it is necessary to consider perceived usefulness from the perspective of different professions/health care services for young children and professional roles (eg, practitioners vs leaders), which, to the best of our knowledge, has not been previously studied directly.…”

Experiences from implementation of internet-delivered cognitive behaviour therapy for insomnia in psychiatric health care: a qualitative study applying the NASSS framework

“…However, despite this, in therapists’ everyday practice, unresolved priority issues formed organisational barriers to the programme’s implementation. Previous studies have highlighted competing demands to the ICBT treatments, especially regarding available time for the therapists to engage in ICBT treatments [ 22 , 26 – 28 ], implying that therapists need protected time for ICBT-i. This barrier also indicates that implementing ICBT in clinics or organisations with a wider health care assignment requires other strategies than in specific ICBT clinics.…”

“…The finding that implementation activities, such as therapist training and supervision, facilitated the implementation, is also supported by previous studies. Training regarding the evidence base for internet-delivered treatment has been shown to facilitate ICBT implementation [ 11 , 26 – 28 ], as well as practical training in the programme itself [ 26 ], supervision of therapists during the intervention [ 11 , 28 ], and technical support [ 25 ]. In a scale-up implementation it is important to meet the continuous need for training, supervision, and support of the ICBT therapists.…”

“…Previous studies on implementation of ICBT have focused on identifying determinants for implementing the new technology in various health care settings, for various conditions, and in various populations [11,[22][23][24][25][26][27][28][29]. Two studies were conducted in psychiatric health care [11,29].…”

The Nurse–Family Partnership in Colorado: Supporting High‐Quality Programming With Implementation Science

“…One generalizable implementation framework that has been applied across disciplines is the AIF (Fixsen, Naoom, Blase, Friedman, & Wallace, ). In addition to demonstrating utility in human services, the evidence‐based AIF has been used in several studies within health care (Drozd, Haga, Lisoy, & Slinning, ; Drozd et al, ; Lala, ; Scovil et al, ). One intermediary organization, IIK, has worked to utilize implementation theory and principles from the AIF to support the high‐quality implementation, scale‐up, and sustainment of the NFP in Colorado.…”