Background: Internet-based Cognitive Behaviour Therapy (iCBT) for depression have been implemented in routine care across Europe in varying ways, at various scales and with varying success. This study aimed to advance our understanding of organisational implementation climate from the perspectives of implementers and mental health service deliverers. Methods: Qualitative and quantitative methods were combined to study the concept of organisational implementation climate in mental health care settings. Based on concept mapping, a qualitative workshop with implementers was used to conceptualise organisational implementation climate for optimizing iCBT use in routine practice. Service deliverers involved in the provision of iCBT were invited to participate in an explorative cross-sectional survey assessing levels of satisfaction and usability of iCBT, and organisational implementation climate in implementing iCBT. The two methods were applied independently to study viewpoints of implementers as well as service deliverers. Corresponding to the explorative nature of the study, inductive reasoning was applied to identify patterns and develop a reasonable explanation of the observations made. Correlative associations between satisfaction, usability and implementation climate were explored. Results: Sixteen implementers representing fourteen service delivery organisations across Europe participated in the workshop. The top-three characteristics of a supportive organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-three tools for creating a supportive implementation climate included: (1) feedback on job performance, (2) progress monitoring in achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. The survey (n=111) indicated that service providers generally regarded their organisational implementation climate as supportive in implementing iCBT services. Organisational implementation climate was weakly associated with perceived usability and moderately with satisfaction with iCBT services. Conclusions: Organisational implementation climate is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. It is not only an inherent characteristic of the context in which implementation takes place, it can also be shaped to improve implementation of iCBT services. Future research should further theorise organisational implementation climate and empirically validate the measurement instruments such as used in this study.
Bibliografisk noteFunding Information:
The authors would like to thank the entire MasterMind project management team, work package leaders, consortium members, and notably the local implementers and service delivery staff for their collaboration, advice and insights. Named MasterMind consortium members included amongst others (alphabetical order): Olatz Albaina, Institute for health services research-Kronikgune, Spain Marco Cavallo, Ph.D., eCampus University, Novedrate, Italy Els Dozeman, MD, Ph.D., GGZ inGeest, Amsterdam, Netherlands Claus Duedal Pedersen, Sentinel Unit, Sundhed.dk, Odense, København, Denmark Prof. David Ebert, Ph.D, Friedrich-Alexander University Erlangen-Nürnberg, GET.ON Insitute (HelloBetter) Anne Etzelmüller, GET.ON Institute (HelloBetter), Germany Erik van der Eycken, GAMIAN Europe, Belgium Ane Fullaondo, Ph.D, Institute for health services research, Kronikgune, Spain Andrea Gabilondo, Basque Health Service, Osakidetza, Spain Ana González Pinto, Basque Health Service, Osakidetza, Spain Begoña Gutiérrez, Basque Health Service, Osakidetza, Spain Annet Kleiboer, Ph.D., Clinical, Neuro-, & Developmental Psychology, VU Amsterdam, the Netherlands Elisabeth Kohls, Ph.D. Department of Psychiatry and Psychotherapy, University Leipzig, Leipzig, Germany Esteban de Manuel, Institute for health services research-Kronikgune, Spain Kim Mathiasen, Ph.D. Internet Psychiatrien, Region of Southern Denmark, Arhus University Hospital, Denmark Mayke Mol, GGZ InGeest, the Netherlands Joana Mora, Institute for health services research-Kronikgune, Spain Luisa Peleteiro-Pensado, MD, Servizo Galego de Saúde. Complejo hospitalario universitario de Ourense, Spain Joaquín Ponte, Basque Health Service, Osakidetza, Spain Prof. Kevin Power, Ph.D., NHS Tayside Psychological Therapies Service, Scotland Ander Retolaza, Basque Health Service, Osakidetza, Spain Prof. Heleen Riper, Ph.D., Clinical, Neuro-, & Developmental Psychology, VU Amsterdam, the Netherlands Ylenia Sacco, Dipartimento di Salute Mentale, Azienda Sanitaria Locale Torino 3, Turin, Italy Anneke van Schaik, MD, Ph.D., GGZ inGeest, Amsterdam, Netherlands. Modesto Sierra Callau, Servicio Aragonés de Salud, Spain Mette Maria Skjøth, Centre for Innovative Medical Technology, Odense University Hospital, Denmark Prof. Jan Smit, Ph.D., GGZ InGeest, the Netherlands Melita Sogomonjan, Tallinn University of Technology, Estonia Maria Tajes-Alonso, MD, Servizo Galego de Saúde. Consellería de Sanidade. Spain Jon Txarramendieta, Institute for health services research-Kronikgune, Spain Christiaan Vis, Clinical, Neuro-, & Developmental Psychology, VU Amsterdam, the Netherlands Chris Wright, NHS Tayside Psychological Therapies Service, Scotland Prof. Enrico Zanalda, MD, Ph.D. Dipartimento di Salute Mentale, Azienda Sanitaria Locale Torino 3, Turin, Italy
The MasterMind project was partly funded under the ICT Policy Support Programme (ICT PSP) as part of the Competitiveness and Innovation Framework Programme (CIP) by the European Community (Grant Agreement number: 621000). This funding body had no influence on the design, execution, analysis, or interpretation of the results of this study.
© 2022, The Author(s).