Monash University and Alfred Health, Melbourne, Victoria, Australia.
Alfred Health, Melbourne, Victoria, Australia.
Health Expect. 2024 Feb;27(1):e13989. doi: 10.1111/hex.13989.
Codesigned interventions are becoming more common in health services and, in particular, in the design and development of mental health programmes and interventions. However, previous research has established that the transition from codesign to implementation can experience several challenges and that this transition process has received little research attention.
The aim of this study was to explore the experience of staff members charged with the implementation of a codesigned intervention for young people and adolescents at risk of suicide.
Five staff members involved in the implementation of the new codesigned programme took part in semi-structured interviews.
The study involved qualitative evaluation of staff experiences during the implementation of a new child and youth suicide intervention. Interviews were analysed using reflexive thematic analysis.
The analysis identified four themes of 'disconnect', 'operational challenges, 'service user' and 'being authentic'. 'Disconnect' captures the difficulties of implementing a codesigned programme which leads to 'operational challenges' in meeting broader expectations while ensuring the feasibility of the programme. The third theme, 'service user', captures the realisation that the young people accessing the new service were different to those involved in the codesign process. The final theme, 'being authentic', highlights how staff needed to be responsive and flexible while remaining true to the principles proposed in the codesign.
This study yielded some valuable insights into the challenges around the implementation of a codesigned intervention, an under-researched area. The findings suggest that adaption of the design may be necessary, if it is not informed by implementation constraints, making it necessary for the implementation team to be well-briefed on the initial design and given plenty of time to make the necessary adjustments in a coproduction process. Limitations for the generalisation of the results include a small sample of staff and particular challenges that may be unique to this study.
The present study highlights that for health services undertaking codesign approaches, appropriate time and resources need to be considered for the implementation phase of an initiative, to ensure that there is effective translation from design to implementation and that new codesigned services can be effective within operational constraints.
The authors would like to thank and acknowledge the young people with a lived-experience and their carers who participated in the codesign process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in the evaluation.
联合设计干预措施在卫生服务中越来越普遍，特别是在设计和开发心理健康计划和干预措施方面。然而，先前的研究已经确定，从联合设计到实施的过渡可能会遇到几个挑战，而这一过渡过程还没有得到太多研究关注。
本研究旨在探讨负责实施针对有自杀风险的年轻人和青少年的联合设计干预措施的工作人员的经验。
参与新的联合设计方案实施的五名工作人员参加了半结构化访谈。
本研究对新的儿童和青年自杀干预措施实施过程中工作人员的经验进行了定性评估。访谈分析采用反思性主题分析。
分析确定了四个主题：“脱节”、“操作挑战”、“服务使用者”和“真实”。“脱节”捕捉到了实施联合设计方案所带来的困难，导致在满足更广泛的期望的同时，也给方案的可行性带来了“操作挑战”。第三个主题“服务使用者”捕捉到了一个现实，即接触新服务的年轻人与参与联合设计过程的年轻人不同。最后一个主题“真实”突出了工作人员在保持对联合设计提出的原则的响应性和灵活性的同时，需要保持真实。
本研究对联合设计干预措施实施方面的挑战提供了一些有价值的见解，这是一个研究不足的领域。研究结果表明，如果设计没有考虑到实施限制，可能需要对设计进行调整，这使得实施团队需要对初始设计有充分的了解，并在共同制定过程中留出足够的时间进行必要的调整。结果的推广存在一些局限性，包括工作人员样本较小以及本研究可能特有的特定挑战。
本研究强调，对于从事联合设计方法的卫生服务机构，需要考虑到计划实施阶段的适当时间和资源，以确保从设计到实施的有效转化，并且新的联合设计服务能够在操作限制内有效。
作者要感谢并感谢参与联合设计过程和研究评估的有生活经验的年轻人及其照顾者。我们还要感谢参与评估的临床工作人员、同伴工作人员和家庭同伴工作人员。
