Abstract
BackgroundGiven the increasing use of digital interventions in health care, understanding how best to implement them is crucial. However, evidence on how to implement new academically developed interventions in complex health care environments is lacking. This case study offers an example of how to develop a theory-based implementation plan for Partner in Balance, an electronic health (eHealth) intervention to support the caregivers of people with dementia.ObjectiveThe specific objectives of this study were to (1) formulate evidence-based implementation strategies, (2) develop a sustainable business model, and (3) integrate these elements into an implementation plan.MethodsThis case study concerns Partner in Balance, a blended care intervention to support the caregivers of people with dementia, which is effective in improving caregiver self-efficacy, quality of life, and experienced control. The large-scale implementation of Partner in Balance took place in local dementia case-management services, local care homes, dementia support groups, and municipalities. Experiences from real-life pilots (n=22) and qualitative interviews with national stakeholders (n=14) were used to establish an implementation plan consisting of implementation strategies and a business model.ResultsThe main finding was the need for a business model to facilitate decision-making from potential client organizations, who need reliable pricing information before they can commit to training coaches and implementing the intervention. Additionally, knowledge of the organizational context and a wider health care system are essential to ensure that the intervention meets the needs of its target users. Based on these findings, the research team formulated implementation strategies targeted at the engagement of organizations and staff, dissemination of the intervention, and facilitation of long-term project management in the future.ConclusionsThis study offers a theory-based example of implementing an evidence-based eHealth intervention in dementia health care. The findings help fill the knowledge gap on the eHealth implementation context for evidence-based eHealth interventions after the trial phase, and they can be used to inform individuals working to develop and sustainably implement eHealth.
Highlights
Dementia and CaregivingThe combination of an aging population and declining birth rate is proving to be a great challenge for many modern health care systems, resulting in rising costs and spending cuts [1]
This paper describes the implementation of Partner in Balance as a use case to inform http://aging.jmir.org/2020/1/e18624/
This study contributes to literature on the implementation context by providing insights into this important implementation barrier, namely the lack of reliable pricing information for implementing evidence-based electronic health (eHealth) interventions to support the caregivers of people with dementia [48]
Summary
Dementia and CaregivingThe combination of an aging population and declining birth rate is proving to be a great challenge for many modern health care systems, resulting in rising costs and spending cuts [1]. EHealth interventions provide specific advantages to the caregivers of people with dementia, as they can be personalized and adapted to the stage of dementia and allow caregivers to receive psychoeducation without leaving the person with dementia home alone and to seek help without facing the stigma associated with dementia. This case study offers an example of how to develop a theory-based implementation plan for Partner in Balance, an electronic health (eHealth) intervention to support the caregivers of people with dementia. Knowledge of the organizational context and a wider health care system are essential to ensure that the intervention meets the needs of its target users Based on these findings, the research team formulated implementation strategies targeted at the engagement of organizations and staff, dissemination of the intervention, and facilitation of long-term project management in the future. The findings help fill the knowledge gap on the eHealth implementation context for evidence-based eHealth interventions after the trial phase, and they can be used to inform individuals working to develop and sustainably implement eHealth
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