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What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model

BACKGROUND: There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM) to inform the process of implementation o...

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Autores principales: Gask, Linda, Bower, Peter, Lovell, Karina, Escott, Diane, Archer, Janine, Gilbody, Simon, Lankshear, Annette J, Simpson, Angela E, Richards, David A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829490/
https://www.ncbi.nlm.nih.gov/pubmed/20181163
http://dx.doi.org/10.1186/1748-5908-5-15
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author Gask, Linda
Bower, Peter
Lovell, Karina
Escott, Diane
Archer, Janine
Gilbody, Simon
Lankshear, Annette J
Simpson, Angela E
Richards, David A
author_facet Gask, Linda
Bower, Peter
Lovell, Karina
Escott, Diane
Archer, Janine
Gilbody, Simon
Lankshear, Annette J
Simpson, Angela E
Richards, David A
author_sort Gask, Linda
collection PubMed
description BACKGROUND: There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM) to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy. METHODS: Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression. RESULTS: Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration) and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so. CONCLUSIONS: The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation.
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spelling pubmed-28294902010-02-28 What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model Gask, Linda Bower, Peter Lovell, Karina Escott, Diane Archer, Janine Gilbody, Simon Lankshear, Annette J Simpson, Angela E Richards, David A Implement Sci Research Article BACKGROUND: There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM) to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy. METHODS: Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression. RESULTS: Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration) and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so. CONCLUSIONS: The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation. BioMed Central 2010-02-10 /pmc/articles/PMC2829490/ /pubmed/20181163 http://dx.doi.org/10.1186/1748-5908-5-15 Text en Copyright ©2010 Gask et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Gask, Linda
Bower, Peter
Lovell, Karina
Escott, Diane
Archer, Janine
Gilbody, Simon
Lankshear, Annette J
Simpson, Angela E
Richards, David A
What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title_full What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title_fullStr What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title_full_unstemmed What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title_short What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
title_sort what work has to be done to implement collaborative care for depression? process evaluation of a trial utilizing the normalization process model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829490/
https://www.ncbi.nlm.nih.gov/pubmed/20181163
http://dx.doi.org/10.1186/1748-5908-5-15
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