Abstract
BackgroundThe purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway.MethodsA total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes.ResultsAlthough the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life.ConclusionsThe implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice.Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014
Highlights
The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway
The clinicians could not recruit consumers, and they dropped out of consultation after 7 months. They had the lowest score on IMR fidelity after 6 months (M = 3.38)
Because of missing data on the IMR fidelity and General Organizational Index (GOI), this service was excluded from these two analyses
Summary
The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. Much research has been performed on the fidelity of evidence-based interventions (i.e., the degree to which the interventions were implemented as intended in the original programme) [4]. The fidelity of implementation strategies (i.e., methods or techniques, single or multifaceted, used to Egeland et al Int J Ment Health Syst (2017) 11:13 enhance the implementation of the innovation) remains underreported in the health literature [2, 3]. If we fail to improve consumer well being, we need to reconsider our intervention or implementation strategy
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