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Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors.

作者信息

Vis Christiaan, Mol Mayke, Kleiboer Annet, Bührmann Leah, Finch Tracy, Smit Jan, Riper Heleen

机构信息

Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Department of Mental Health, Amsterdam Public Health Research Institute, Vrije Universiteit Medical Center / Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

出版信息

JMIR Ment Health. 2018 Mar 16;5(1):e20. doi: 10.2196/mental.9769.


DOI:10.2196/mental.9769
PMID:29549072
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5878369/
Abstract

BACKGROUND: Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. OBJECTIVE: This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. METHODS: A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. RESULTS: A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. CONCLUSIONS: Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients' mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88c5/5878369/35a83d8219ec/mental_v5i1e20_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88c5/5878369/d543581d1db6/mental_v5i1e20_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88c5/5878369/35a83d8219ec/mental_v5i1e20_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88c5/5878369/d543581d1db6/mental_v5i1e20_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88c5/5878369/35a83d8219ec/mental_v5i1e20_fig2.jpg

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Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors.

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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Attitudes towards digital treatment for depression: A European stakeholder survey.

Internet Interv. 2017-1-25

[2]
Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates.

BMC Med Inform Decis Mak. 2017-6-2

[3]
Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update).

Implement Sci. 2016-10-26

[4]
Implementation, context and complexity.

Implement Sci. 2016-10-19

[5]
The therapist's role in the implementation of internet-based cognitive behavioural therapy for patients with depression: study protocol.

BMC Psychiatry. 2016-9-30

[6]
Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example.

Eval Program Plann. 2017-2

[7]
The Implementation of Internet Interventions for Depression: A Scoping Review.

J Med Internet Res. 2016-9-8

[8]
European COMPARative Effectiveness research on blended Depression treatment versus treatment-as-usual (E-COMPARED): study protocol for a randomized controlled, non-inferiority trial in eight European countries.

Trials. 2016-8-3

[9]
Making sense of implementation theories, models and frameworks.

Implement Sci. 2015-4-21

[10]
Expectations among patients and health professionals regarding Web-based interventions for depression in primary care: a qualitative study.

J Med Internet Res. 2015-3-10

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