Drozd Filip, Haga Silje Marie, Lisøy Carina, Slinning Kari
Department for Infant Mental Health, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
Internet Interv. 2018 May 3;13:1-7. doi: 10.1016/j.invent.2018.04.003. eCollection 2018 Sep.
Despite 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).
Mamma 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.
Twenty-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.
The dissemination and implementation of a health-service supported internet intervention appears to be promising but requires further research.
尽管取得了令人鼓舞的成果，但互联网干预措施在卫生服务中并未广泛普及或得到良好整合。因此，本研究的目的是考察在挪威母婴保健诊所（即初级保健机构）实施的一项预防围产期抑郁症的互联网干预措施（“妈妈咪呀”）。
“妈妈咪呀”干预措施始于孕期中期，持续至产后6个月。它包括44次在线课程，在此期间，助产士和公共卫生护士会在多达5个联系点提供支持，并遵循共情沟通原则。挪威的母婴保健诊所为所有孕妇和0至5岁儿童提供免费的普及性服务，本研究通过一个中介组织招募了这些诊所。在培训前和培训后，但在诊所实施“妈妈咪呀”干预措施之前，以及在3个月和6个月随访时收集数据。定量和定性数据用于评估“妈妈咪呀”干预措施的培训情况，考察项目实施情况（即登记参加该项目的孕妇人数），并确定实施的障碍和促进因素。
本研究招募了来自14家母婴保健诊所的24名自行选择的医护人员。培训增加了参与者对“妈妈咪呀”干预措施的了解，且超出了他们的预期。项目审查和实施计划是必要的培训内容。实施氛围与参与“妈妈咪呀”干预措施的同事数量以及对实施的总体满意度有关，而干预措施的特点则预测了6个月时登记女性的数量。组织重组、领导力和竞争性活动被确定为需要进一步考虑的实施障碍。
一项由卫生服务支持的互联网干预措施的传播和实施似乎前景光明，但需要进一步研究。
