Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)

Roberto Mediavilla; Blanca García-Vázquez; Kerry R. McGreevy; James Underhill; Carmen Bayón; María Fe Bravo-Ortiz; Ainoa Muñoz-Sanjosé; Josep Maria Haro; Anna Monistrol-Mula; Pablo Nicaise; Papoula Petri-Romão; David McDaid; A. La Park; Maria Melchior; Cécile Vuillermoz; Giulia Turrini; Beatrice Compri; Marianna Purgato; Rinske Roos; Anke B. Witteveen; Marit Sijbrandij; Richard A. Bryant; Daniela Fuhr; José Luis Ayuso-Mateos

doi:10.1177/20552076241287678

Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)

Roberto Mediavilla, Blanca García-Vázquez, Kerry R. McGreevy^*, James Underhill, Carmen Bayón, María Fe Bravo-Ortiz, Ainoa Muñoz-Sanjosé, Josep Maria Haro, Anna Monistrol-Mula, Pablo Nicaise, Papoula Petri-Romão, David McDaid, A. La Park, Maria Melchior, Cécile Vuillermoz, Giulia Turrini, Beatrice Compri, Marianna Purgato, Rinske Roos, Anke B. WitteveenMarit Sijbrandij, Richard A. Bryant, Daniela Fuhr, José Luis Ayuso-Mateos

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Objectives: This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action. Methods: We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo. Results: Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components. Conclusions: These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support. Trial registration number: NCT04980326.

Original language	English
Pages (from-to)	1-20
Number of pages	20
Journal	Digital Health
Volume	10
Early online date	18 Oct 2024
DOIs	https://doi.org/10.1177/20552076241287678
Publication status	Published - Dec 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Funding

The RESPOND project was funded by the European Commission under Horizon 2020 \u2013 the Framework Programme for Research and Innovation (2014\u20132020) (grant number: 101016127). The work of RM was funded by the Instituto de Salud Carlos III (CD22/00061). The funders did not have any role in the study design, data collection, data analysis, or manuscript writing and submission. The content of this article reflects only the authors\u2019 views and the European Commission is not responsible for any use that may be made of the information it contains.

Funders	Funder number
European Commission
Horizon 2020
Horizon 2020 Framework Programme	101016127
Instituto de Salud Carlos III	CD22/00061

Keywords

eHealth
health care
healthcare workers
internet-based intervention
Mental health
process assessment
qualitative evaluation
quantitative evaluation

Access to Document

10.1177/20552076241287678

Persistent URL (handle)

Persistent link

Cite this

Mediavilla, R., García-Vázquez, B., McGreevy, K. R., Underhill, J., Bayón, C., Bravo-Ortiz, M. F., Muñoz-Sanjosé, A., Haro, J. M., Monistrol-Mula, A., Nicaise, P., Petri-Romão, P., McDaid, D., Park, A. L., Melchior, M., Vuillermoz, C., Turrini, G., Compri, B., Purgato, M., Roos, R., ... Ayuso-Mateos, J. L. (2024). Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs). Digital Health, 10, 1-20. https://doi.org/10.1177/20552076241287678

@article{ea9f412d151a4312b3e7635b5d8ddfed,

title = "Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)",

abstract = "Objectives: This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action. Methods: We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo. Results: Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components. Conclusions: These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support. Trial registration number: NCT04980326.",

keywords = "eHealth, health care, healthcare workers, internet-based intervention, Mental health, process assessment, qualitative evaluation, quantitative evaluation",

author = "Roberto Mediavilla and Blanca Garc{\'i}a-V{\'a}zquez and McGreevy, {Kerry R.} and James Underhill and Carmen Bay{\'o}n and Bravo-Ortiz, {Mar{\'i}a Fe} and Ainoa Mu{\~n}oz-Sanjos{\'e} and Haro, {Josep Maria} and Anna Monistrol-Mula and Pablo Nicaise and Papoula Petri-Rom{\~a}o and David McDaid and Park, {A. La} and Maria Melchior and C{\'e}cile Vuillermoz and Giulia Turrini and Beatrice Compri and Marianna Purgato and Rinske Roos and Witteveen, {Anke B.} and Marit Sijbrandij and Bryant, {Richard A.} and Daniela Fuhr and Ayuso-Mateos, {Jos{\'e} Luis}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

doi = "10.1177/20552076241287678",

language = "English",

volume = "10",

pages = "1--20",

journal = "Digital Health",

issn = "2055-2076",

publisher = "SAGE Publications",

}

Mediavilla, R, García-Vázquez, B, McGreevy, KR, Underhill, J, Bayón, C, Bravo-Ortiz, MF, Muñoz-Sanjosé, A, Haro, JM, Monistrol-Mula, A, Nicaise, P, Petri-Romão, P, McDaid, D, Park, AL, Melchior, M, Vuillermoz, C, Turrini, G, Compri, B, Purgato, M, Roos, R , Witteveen, AB , Sijbrandij, M, Bryant, RA, Fuhr, D & Ayuso-Mateos, JL 2024, 'Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)', Digital Health, vol. 10, pp. 1-20. https://doi.org/10.1177/20552076241287678

TY - JOUR

T1 - Beyond effectiveness in eHealth trials

T2 - Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)

AU - Mediavilla, Roberto

AU - García-Vázquez, Blanca

AU - McGreevy, Kerry R.

AU - Underhill, James

AU - Bayón, Carmen

AU - Bravo-Ortiz, María Fe

AU - Muñoz-Sanjosé, Ainoa

AU - Haro, Josep Maria

AU - Monistrol-Mula, Anna

AU - Nicaise, Pablo

AU - Petri-Romão, Papoula

AU - McDaid, David

AU - Park, A. La

AU - Melchior, Maria

AU - Vuillermoz, Cécile

AU - Turrini, Giulia

AU - Compri, Beatrice

AU - Purgato, Marianna

AU - Roos, Rinske

AU - Witteveen, Anke B.

AU - Sijbrandij, Marit

AU - Bryant, Richard A.

AU - Fuhr, Daniela

AU - Ayuso-Mateos, José Luis

PY - 2024/12

Y1 - 2024/12

N2 - Objectives: This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action. Methods: We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo. Results: Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components. Conclusions: These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support. Trial registration number: NCT04980326.

AB - Objectives: This study presents the process evaluation of an effective stepped-care programme of eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) for healthcare workers (HCWs) with psychological distress (RESPOND-HCWs trial) conducted in Spain. The aim is to analyse the context in which the programme was delivered, assess key implementation outcomes and explore mechanisms of action. Methods: We used mixed methods. Quantitative data came from routine randomised control trial monitoring and structured observation, and qualitative data were collected using semi-structured, in-depth interviews with trial participants (n = 12) and decision-makers (n = 7) and a focus group discussion with intervention providers (n = 7). We conducted a descriptive analysis of quantitative data using R software and a thematic analysis of qualitative data using NVivo. Results: Context analysis revealed implementation barriers, including unrealistic expectations of participants about the programme and mental health-related stigma. The flexibility of interventions and the opportunity for mental health actions were enabling factors. Implementation outcomes showed that the trial was feasible, appropriate and timely, and that the intervention was delivered with minimal protocol deviations and good acceptance among participants. Mechanisms of action included confidence in the positive effect of the intervention, a good therapeutic relationship and specific intervention components. Conclusions: These results supplement the outcome evaluation and can help inform large-scale implementation in similar settings. Specific recommendations include increasing mental health awareness and reducing stigma in the implementation setting, including a short orientation session and ensuring flexibility in schedules and peer support. Trial registration number: NCT04980326.

KW - eHealth

KW - health care

KW - healthcare workers

KW - internet-based intervention

KW - Mental health

KW - process assessment

KW - qualitative evaluation

KW - quantitative evaluation

UR - http://www.scopus.com/inward/record.url?scp=85207169686&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85207169686&partnerID=8YFLogxK

U2 - 10.1177/20552076241287678

DO - 10.1177/20552076241287678

M3 - Article

AN - SCOPUS:85207169686

SN - 2055-2076

VL - 10

SP - 1

EP - 20

JO - Digital Health

JF - Digital Health

ER -

Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs)

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this