Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
GET.ON Institute, Berlin, Germany.
BMC Psychiatry. 2020 Aug 27;20(1):424. doi: 10.1186/s12888-020-02800-z.
Farmers are a vulnerable population for developing depression or other mental health disorders due to a variety of risk factors in their work context. Beyond face-to-face resources, preventive internet- and tele-based interventions could extend available treatment options to overcome barriers to care. The German Social Insurance Company for Agriculture, Forestry and Horticulture (SVLFG) implements several guided internet- and mobile-based interventions and personalised tele-based coaching for this specific target group provided by external companies within a nation-wide prevention project for their insured members. The current study aims to evaluate the implementation process and to identify determinants of successful implementation on various individual and organisational levels.
The current study includes two groups of participants: 1) insured persons with an observable need for prevention services, and 2) staff-participants who are involved in the implementation process. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR) will be used to track and evaluate the implementation process. A mixed-method approach will provide insights on individual and organizational level (e.g. degree of normalization, readiness for change) and helps to identify determinants of successful implementation. In-depth insights on experiences of the participants (e.g. acceptance, satisfaction, barriers and facilitating factors of intervention use) will be yielded through qualitative interviews. Focus groups with field workers provide insights into barriers and facilitators perceived during their consultations. Furthermore, intervention as well as implementation costs will be evaluated. According to the stepwise, national rollout, data collection will occur at baseline and continuously across 24 months.
The results will show to what extent the implementation of the internet- and tele-based services as a preventive offer will be accepted by the participants and involved employees and which critical implementation aspects will occur within the process. If the implementation of the internet- and tele-based services succeeds, these services may be feasible in the long-term.
German Clinical Trial Registration: DRKS00017078 . Registered on 18.04.2019.
农民由于工作环境中存在各种风险因素，容易患上抑郁症或其他心理健康障碍。除了面对面的资源外，预防性的互联网和远程干预措施可以提供更多的治疗选择，以克服护理障碍。德国农业、林业和园艺社会保险协会（SVLFG）在全国范围内的预防项目中，为其参保人员实施了由外部公司提供的几种针对特定目标群体的有指导的互联网和移动为基础的干预措施，以及个性化的远程辅导。本研究旨在评估实施过程，并确定在各个个人和组织层面上成功实施的决定因素。
本研究包括两组参与者：1）有可观察到预防服务需求的参保人员，以及 2）参与实施过程的工作人员。将使用可达性、有效性、采用、实施和维持（RE-AIM）框架和综合实施研究框架（CFIR）来跟踪和评估实施过程。混合方法将提供对个人和组织层面（例如，正常化程度、变革准备程度）的深入了解，并有助于确定成功实施的决定因素。通过定性访谈，可以深入了解参与者的经验（例如，接受度、满意度、干预使用的障碍和促进因素）。与实地工作者进行焦点小组讨论，可深入了解他们在咨询过程中所感知到的障碍和促进因素。此外，还将评估干预措施和实施成本。根据逐步的全国推广，数据将在 24 个月的基线和连续时间点进行收集。
研究结果将显示，互联网和远程服务作为一种预防措施，在多大程度上会被参与者和相关员工所接受，以及在实施过程中会出现哪些关键的实施方面。如果互联网和远程服务的实施取得成功，这些服务在长期内可能是可行的。
德国临床试验注册：DRKS00017078。注册于 2019 年 4 月 18 日。
