Christie Hannah Liane, Boots Lizzy Mitzy Maria, Tange Huibert Johannes, Verhey Frans Rochus Josef, de Vugt Marjolein Elizabeth
Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands.
Department of Family Practice, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
JMIR Aging. 2021 Feb 5;4(1):e21629. doi: 10.2196/21629.
Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context in which to implement these interventions due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in 8 municipalities in the Euregion Meuse-Rhine. Partner in Balance is a blended care, 8-week, self-management intervention intervention designed to aid caregivers of people with dementia in adapting to their new roles that is delivered through coaches in participating health care organizations who are trained to use it to offer online support to their clients. Myinlife is an eHealth/mHealth intervention integrated into the Dutch Alzheimer's Association website and available from the App Store or Google Play, designed to help caregivers of people with dementia use their social network to better organize care and share positive (caregiving) experiences.
This study's objectives were to evaluate the success of the implementation of Myinlife and Partner in Balance and investigate determinants of their successful implementation in the municipality context.
This study collected eHealth use data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials based on the measurement instrument for determinants of implementation (MIDI). These data from multiple sources and perspectives were integrated and analyzed to form a total picture of the determinants (barriers and facilitators to implementation in the municipality context).
The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, 3 municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The 2 Partner in Balance municipalities that did not consider the implementation to be successful viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and target groups. Successful implementations were linked to implementer self-efficacy and sense of ownership, which seemed to be absent in unsuccessful implementations.
The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols as part of standard implementation materials for municipalities and organizations implementing Myinlife and Partner in Balance.
针对痴呆症患者照料者的循证电子健康干预措施在实际中很少得到实施。由于市政当局在（痴呆症）照料和预防方面有可用的政策及创新激励措施，因此是实施这些干预措施的一个有前景的环境。在本研究中，针对痴呆症患者照料者的两项循证电子健康干预措施（平衡伙伴和我的生活）在默兹 - 莱茵河地区的8个市政当局中实施。平衡伙伴是一种混合式护理、为期8周的自我管理干预措施，旨在帮助痴呆症患者照料者适应新角色，通过参与的医疗保健机构中经过培训的教练来实施，这些教练利用该措施为其客户提供在线支持。我的生活是一种集成到荷兰阿尔茨海默病协会网站且可从应用商店或谷歌应用商店获取的电子健康/移动健康干预措施，旨在帮助痴呆症患者照料者利用其社交网络更好地组织护理并分享积极的（照料）体验。
本研究的目的是评估我的生活和平衡伙伴实施的成功情况，并调查它们在市政当局环境中成功实施的决定因素。
本研究收集了电子健康使用数据、平衡伙伴教练评估问卷以及关于实施决定因素的信息。这是通过基于实施决定因素测量工具（MIDI）对市政官员进行访谈来完成的。对来自多个来源和视角的这些数据进行整合和分析，以形成实施决定因素（市政当局环境中实施的障碍和促进因素）的全貌。
平衡伙伴和我的生活在市政当局的实施显示出不同程度的成功。最终，3个市政当局计划继续实施平衡伙伴，而没有一个计划继续实施我的生活。认为实施不成功的2个平衡伙伴市政当局将实施视为一个外部项目。对于我的生活，显然需要更多面对面接触来吸引实施市政当局和目标群体。成功的实施与实施者的自我效能感和主人翁意识相关，而在不成功的实施中似乎缺乏这些。
实施这些干预措施的经验表明，就所需预算和基础设施而言，这种实施环境是可行的。培养实施者的主人翁意识和自我效能感的需求将作为实施我的生活和平衡伙伴的市政当局及组织的标准实施材料的一部分纳入未来的实施方案。
