Ball Hannah, Eisner Emily, Nicholas Jennifer, Wilson Paul, Bucci Sandra
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, School of Health Sciences, The University of Manchester, Manchester, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
BMC Public Health. 2025 Mar 17;25(1):1023. doi: 10.1186/s12889-025-22189-2.
Digital health interventions have the potential to improve the efficacy and accessibility of mental health services for people with severe mental health problems, but their integration into routine practice is a challenge. The real-world implementation of digital health interventions should be considered alongside digital intervention development. However, little is known about the quality of implementation research in this area, including the extent to which implementation science theories, models and frameworks are used. The aim of this review was to synthesise evidence regarding the application of theories, models and frameworks in research investigating the implementation of digital health interventions in services for people with severe mental health problems. Secondary aims were to consider the contexts within which studies had been undertaken and the degree of service user involvement in this research.
A scoping review method was employed. Electronic databases were systematically searched for published papers in English and reference lists of included studies were hand searched. Included studies used an implementation science theory, model, or framework to understand, guide or evaluate the implementation of digital health interventions in services for people with severe mental health problems.
Twelve eligible studies were identified. Studies were primarily undertaken in community mental health services with staff participants and there was variation in the types of digital interventions that were investigated. Eight different implementation science theories, models, and frameworks were used and were mainly employed to guide qualitative analysis. Most studies were undertaken in the early exploratory stages of implementation projects and there was little evidence regarding factors affecting the longer-term sustainment of digital health interventions in practice. Only one study reported the inclusion of service users in the design of the implementation study.
The use of implementation theories, models, and frameworks in efforts to implement digital health interventions in routine care for people with severe mental health problems is limited. Researchers should consider integrating such approaches throughout the research process and ensure service users are involved in this work. Further research regarding implementation processes, and the reach and sustainment of digital health interventions in routine practice, is required.
数字健康干预措施有潜力改善为严重精神健康问题患者提供的精神健康服务的效果和可及性，但将其整合到常规实践中是一项挑战。数字健康干预措施的实际应用应与数字干预措施的开发同时考虑。然而，对于该领域实施研究的质量，包括实施科学理论、模型和框架的使用程度，人们了解甚少。本综述的目的是综合关于理论、模型和框架在研究数字健康干预措施在严重精神健康问题患者服务中的应用的证据。次要目的是考虑开展研究的背景以及服务使用者在该研究中的参与程度。
采用了范围综述方法。系统检索电子数据库中的英文发表论文，并人工检索纳入研究的参考文献列表。纳入研究使用实施科学理论、模型或框架来理解、指导或评估数字健康干预措施在严重精神健康问题患者服务中的应用。
确定了12项符合条件的研究。研究主要在社区精神健康服务机构中开展，参与者为工作人员，所研究的数字干预措施类型存在差异。使用了8种不同的实施科学理论、模型和框架，主要用于指导定性分析。大多数研究是在实施项目的早期探索阶段进行的，几乎没有证据表明哪些因素会影响数字健康干预措施在实践中的长期可持续性。只有一项研究报告在实施研究设计中纳入了服务使用者。
在为严重精神健康问题患者的常规护理中实施数字健康干预措施时，实施理论、模型和框架的使用有限。研究人员应考虑在整个研究过程中整合此类方法，并确保服务使用者参与这项工作。需要进一步研究实施过程以及数字健康干预措施在常规实践中的覆盖范围和可持续性。
