Fortuna Karen L, Divatia Shreya, Neupane Sudeep, Geiger Pamela, Bohm Andrew
Department of Psychiatry, Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, United States.
Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX, United States.
Front Digit Health. 2023 Jul 20;5:1130095. doi: 10.3389/fdgth.2023.1130095. eCollection 2023.
Certified peer support specialists often use technologies such as smartphone applications to deliver digital peer support in community mental health centers. Certified peer support specialists are individuals with a mental health diagnosis, trained and accredited by their state to provide mental health support services. Digital peer support has shown promising evidence of promoting recovery, hope, social support, and medical and psychiatric self-management among patients with a diagnosis of a serious mental illness. Interest in digital peer support as part of the patient experience has grown. Understanding barriers and facilitators to the implementation process of digital peer support into community mental health centers is a critical next step to facilitate uptake.
Semi-structured qualitative interviews were conducted with 27 patient participants (= 17 persons with serious mental illness; = 10 certified peer support specialists) from an urban community mental health center. Participants responded to open-ended questions on the barriers and facilitators of engaging with digital peer support technologies within community mental health centers. The interview guide and the responses were categorized according to the Consolidated Framework for Implementation Science Research (CFIR) constructs.
Nine and two were identified for the implementation of digital peer support in community mental health centers. The overarching domains for the identified barriers included (1) intervention characteristics (i.e., adaptability, complexity, and cost), (2) inner settings (i.e., implementation climate, readiness for implementation, and access to knowledge and information), and (3) characteristics of individuals (i.e., knowledge and beliefs about the intervention and other personal attributes). The two facilitators identified included (1) intervention characteristics (i.e., relative advantage) and (2) outer setting (i.e., patient needs and resources).
The identified barriers and facilitators represent a starting point for developing or modifying digital peer support technology requirements to ease implementation in community mental health centers. Building technology requirements and implementation processes based on these findings may facilitate uptake of digital peer support technologies by people with serious mental illness and certified peer support specialists in community mental health centers.
认证同伴支持专家经常使用智能手机应用程序等技术，在社区心理健康中心提供数字同伴支持。认证同伴支持专家是患有心理健康诊断的个人，经所在州培训并认可，以提供心理健康支持服务。数字同伴支持已显示出在促进患有严重精神疾病诊断的患者康复、希望、社会支持以及医疗和精神自我管理方面有令人鼓舞的证据。作为患者体验一部分的数字同伴支持的兴趣日益增长。了解数字同伴支持在社区心理健康中心实施过程中的障碍和促进因素是促进采用的关键下一步。
对来自城市社区心理健康中心的27名患者参与者（=17名患有严重精神疾病的人；=10名认证同伴支持专家）进行了半结构化定性访谈。参与者回答了关于在社区心理健康中心使用数字同伴支持技术的障碍和促进因素的开放式问题。访谈指南和回答根据实施科学研究综合框架（CFIR）结构进行分类。
确定了社区心理健康中心实施数字同伴支持的九个障碍和两个促进因素。确定的障碍的总体领域包括：（1）干预特征（即适应性、复杂性和成本），（2）内部环境（即实施氛围、实施准备情况以及知识和信息获取），以及（3）个人特征（即对干预的知识和信念以及其他个人属性）。确定的两个促进因素包括：（1）干预特征（即相对优势）和（2）外部环境（即患者需求和资源）。
确定的障碍和促进因素是开发或修改数字同伴支持技术要求的起点，以便在社区心理健康中心更轻松地实施。基于这些发现构建技术要求和实施流程可能会促进社区心理健康中心的严重精神疾病患者和认证同伴支持专家采用数字同伴支持技术。
