Factors to consider during the implementation of nutrition and physical activity trials for people with psychotic illness into an Australian community setting

BMC Health Serv Res. 2020 Aug 12;20(1):743. doi: 10.1186/s12913-020-05629-0.

Abstract

Background: Research in lifestyle interventions focusing on nutrition and physical activity in people living with psychotic illness, highlights anthropometric and metabolic benefits of these interventions. However, little is known about potential factors to consider during implementation into real-world contexts. Community-managed organisations (CMOs) that provide services for people with mental illness, offer an ideal implementation context for lifestyle interventions. Successful translation of lifestyle interventions into CMOs may be achieved though considering the factors associated with program access and delivery in these settings. This study primarily aimed to identify the factors that affect program access in a local CMO from the perspective of consumers and staff. The secondary aim was to describe the elements that impact on program delivery from the perspective of staff.

Methods: Thirteen semi-structured interviews were conducted with 6 consumers and 7 staff in a CMO in regional Australia. Topics explored in interviews were based on implementation concepts identified in the "Integrated Promoting Action on Research Implementation in Health Systems" (i-PARIHS) knowledge translation framework. Thematic data analysis was conducted using Nvivo software.

Results: Emergent themes on issues that influenced program access were (1) consumer financial status, domestic responsibilities, and health; (2) the design and delivery of programs; (3) structure and practices of the organisation; (4) attitude, skills and effort of staff involved in program delivery; and (5) social connections and stigma experienced by consumers during program access. Moreover, staff perceptions on elements that impacted program delivery highlighted themes on consumer attendance and interest in prospective programs, availability and restrictions to the use of funding, as well as the organisational structure and practices.

Conclusions: The factors affecting program access and delivery can generally be managed or planned for during the design of lifestyle interventions and subsequent translation into the CMO context. However, resolution of issues related to consumer financial status and health requires the collaboration of various government sectors for system-wide solutions.

Keywords: Community managed organisations; Knowledge translation; Lifestyle interventions; Mental health; Psychotic illness.

MeSH terms

  • Adult
  • Australia
  • Clinical Trials as Topic / organization & administration*
  • Community Mental Health Services / organization & administration*
  • Exercise*
  • Health Personnel / psychology
  • Health Services Accessibility
  • Health Services Research
  • Humans
  • Life Style
  • Mental Disorders / therapy*
  • Nutritional Status*
  • Qualitative Research
  • Translational Research, Biomedical