Trial staff views on barriers recruitment in a digital intervention for psychosis and how to work around them: A qualitative study within a trial using focus groups and observation (Preprint)

2020 ◽  
Author(s):  
Stephanie Allan ◽  
Hamish McLeod ◽  
Simon Bradstreet ◽  
Imogen Bell ◽  
Helen Whitehill ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Community Mental Health ◽  
Focus Groups ◽  
Point Of View ◽  
Feasibility Trial ◽  
Health Staff ◽  
Emotional Labour ◽  
Trial Staff ◽  
Recruitment Barriers

BACKGROUND Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail within the literature. While trial staff have expertise in describing barriers and facilitators to recruitment a specific focus on understanding recruitment from the point of view of trial staff is rare. OBJECTIVE The primary aim of this study was to understand recruitment from the point of view of trial staff and discover what they considered to be important. METHODS We applied pluralistic ethnographic methods including analysis of trial documents, observation and focus groups explored the recruitment processes of the EMPOWER feasibility trial (ISRCTN: 99559262) RESULTS Recruitment barriers fell into two main themes; service characteristics (lack of time available to mental health staff to support recruitment, staff turnover, patient turnover (within Australia only), management styles of community mental health teams, physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labour (trial staff managing feelings and expressions in order to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams. CONCLUSIONS Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial. CLINICALTRIAL ISRCTN: 99559262 INTERNATIONAL REGISTERED REPORT RR2-10.2196/15634

Trial staff views on barriers recruitment in a digital intervention for psychosis and how to work around them: A qualitative study within a trial

2020 ◽  
Author(s):  
Stephanie Allan ◽  
Hamish Mcloed ◽  
Simon Bradstreet ◽  
Emma Morton ◽  
Imogen Bell ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Community Mental Health ◽  
Research Participation ◽  
Feasibility Trial ◽  
Health Staff ◽  
Mental Health Staff ◽  
Emotional Labour ◽  
Trial Staff ◽  
Recruitment Barriers

Abstract Background: Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail within the literature. While trial staff have expertise in describing barriers and facilitators to recruitment a specific focus on understanding recruitment from the point of view of trial staff is rare.Methods: We applied pluralistic ethnographic methods including analysis of trial documents, observation and focus groups explored the recruitment processes of the EMPOWER feasibility trial (ISRCTN: 99559262).Results: Recruitment barriers fell into two main themes; service characteristics (lack of time available to mental health staff to support recruitment, staff turnover, patient turnover (within Australia only), management styles of community mental health teams, physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labour (trial staff managing feelings and expressions in order to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams.Conclusions: Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial.Trial Registration: (ISRCTN: 99559262 registered 21/12/2015)

scholarly journals Perspectives of Trial Staff on the Barriers to Recruitment in a Digital Intervention for Psychosis and How to Work Around Them: Qualitative Study Within a Trial (Preprint)

2020 ◽  
Author(s):  
Stephanie Allan ◽  
Hamish Mcleod ◽  
Simon Bradstreet ◽  
Imogen Bell ◽  
Helen Whitehill ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Community Mental Health ◽  
Well Being ◽  
Point Of View ◽  
Feasibility Trial ◽  
Health Staff ◽  
Mental Health Staff ◽  
Trial Staff ◽  
Recruitment Barriers

BACKGROUND Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail in the literature. Although trial staff have expertise in describing barriers to and facilitators of recruitment, a specific focus on understanding recruitment from the point of view of trial staff is rare, and because trial staff are responsible for meeting recruitment targets, a lack of research on their point of view is a key limitation. OBJECTIVE The primary aim of this study was to understand recruitment from the point of view of trial staff and discover what they consider important. METHODS We applied pluralistic ethnographic methods, including analysis of trial documents, observation, and focus groups, and explored the recruitment processes of the EMPOWER (Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-being, Engagement, and Recovery) feasibility trial, which is a digital app–based intervention for people diagnosed with schizophrenia. RESULTS Recruitment barriers were categorized into 2 main themes: service characteristics (lack of time available for mental health staff to support recruitment, staff turnover, patient turnover [within Australia only], management styles of community mental health teams, and physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labor (trial staff managing feelings and expressions to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams. CONCLUSIONS Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly and to negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial.

scholarly journals Perspectives of Trial Staff on the Barriers to Recruitment in a Digital Intervention for Psychosis and How to Work Around Them: Qualitative Study Within a Trial

10.2196/24055 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e24055
Author(s):  
Stephanie Allan ◽  
Hamish Mcleod ◽  
Simon Bradstreet ◽  
Imogen Bell ◽  
Helen Whitehill ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Community Mental Health ◽  
Well Being ◽  
Point Of View ◽  
Feasibility Trial ◽  
Health Staff ◽  
Mental Health Staff ◽  
Trial Staff ◽  
Recruitment Barriers

Background Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail in the literature. Although trial staff have expertise in describing barriers to and facilitators of recruitment, a specific focus on understanding recruitment from the point of view of trial staff is rare, and because trial staff are responsible for meeting recruitment targets, a lack of research on their point of view is a key limitation. Objective The primary aim of this study was to understand recruitment from the point of view of trial staff and discover what they consider important. Methods We applied pluralistic ethnographic methods, including analysis of trial documents, observation, and focus groups, and explored the recruitment processes of the EMPOWER (Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-being, Engagement, and Recovery) feasibility trial, which is a digital app–based intervention for people diagnosed with schizophrenia. Results Recruitment barriers were categorized into 2 main themes: service characteristics (lack of time available for mental health staff to support recruitment, staff turnover, patient turnover [within Australia only], management styles of community mental health teams, and physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labor (trial staff managing feelings and expressions to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams. Conclusions Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly and to negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial.

A point of view: it’s time to stop neglecting community mental health teams

2015 ◽  
Vol 19 (2) ◽  
pp. 95-97
Author(s):  
Flippa Watkeys ◽  
Suzanne Morton
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Design Methodology ◽  
Community Services ◽  
Point Of View ◽  
Wide Scope ◽  
Content Type ◽  
Recent Attention ◽  
Personal Viewpoint

Purpose – The purpose of this paper is to argue that recent attention has been focused on inpatient services at the expense of community mental health teams and that it is time to redress the balance. Design/methodology/approach – This is a personal viewpoint. Findings – In writing this piece it has enabled us to focus on just how widespread the issues are regarding the lack of focus on community services, and that the view and paradigm needs to change on all levels/structures. Services need to recognise the wide scope of community services and the part they inevitably play in someone’s recovery journey. It also throws the spotlight on services working too often in silos deeply affecting people in receipt of the services. Originality/value – To stimulate debate about the role of community mental health teams.

scholarly journals “Lost between the interface of physical and mental health”: focus groups exploring liaison psychiatry staff's perception about working during the first wave of the COVID-19 pandemic in Birmingham and Solihull Mental Health Foundation Trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S329-S329
Author(s):  
Saima Jehanzeb ◽  
Muhammad Suleman ◽  
Ella Tumelty ◽  
Joanne Okusanya ◽  
Laxsan Karunanithy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Focus Groups ◽  
Working Conditions ◽  
Community Mental Health Services ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
Mental Health Foundation

AimsAs the COVID-19 pandemic continues, increasing attention is being drawn to the welfare of healthcare providers who have endured many months of sustained exposure to the virus, disrupted working conditions and psychological stress. This project aimed to explore the subjective experiences of staff working in Liaison Psychiatry (LP) in the Birmingham and Solihull Mental Health Foundation Trust, (BSMHFT) during the first wave of the COVID-19 pandemic. These findings have been used to devise recommendations for subsequent waves.MethodData collection occurred as part of a mixed method service evaluation project. We invited all clinical and non-clinical staff from LP departments across BSMHFT to participate in focus groups conducted via Microsoft Teams. The focus groups were video-recorded and facilitated by a moderator and an observer. Subsequent anonymised transcripts were coded and themes were generated by at least two evaluators, using thematic analysis.ResultThe focus groups, which ranged from 21 to 69 minutes, involved consultants, junior doctors and nurses from four hospitals within BSMHFT. Six major themes emerged including an initial reduction in number yet increase in acuity of patients seen by LP, with some perception that this resulted from reduced face-to-face contact with community mental health services. A feeling that LP was lost at the interface between the physical and mental health trusts emerged as another theme. Uncertainty in adapting to unprecedented working conditions, for example, unclear guidance concerning the use of personal protective equipment, was also described alongside anxiety about contracting and transmitting SARS-Cov-2. Additionally, increased pressure was felt due to staff shortages and inadequate inter-departmental communication. Participants reported differential uptake of remote working, as well as conflicting views regarding the feasibility of remote assessments in LP.ConclusionLiaison psychiatry staff within BSMHFT continued to provide a crucial service during the COVID-19 pandemic. Focus groups with thes staff indicate several recommendations for implementation within the Trust and provoke questions for future research. Due to the unique role that LP plays in providing mental health care within general hospitals, clear guidance for LP staff is key for effective service provision and supporting LP staff. Although used widely across community mental health services, the role of remote working in LP is contentious and requires further exploration. However, there are limitations to the use of focus groups and these findings may not fully represent the experiences of LP staff throughout BSMHFT. Different themes may have emerged through the use of anonymous questionnaires.

scholarly journals An Affective-Appraisal Approach for Parental Shared Decision Making in Children and Young People's Mental Health Settings: A Qualitative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Shaun Liverpool ◽  
Daniel Hayes ◽  
Julian Edbrooke-Childs
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Focus Groups ◽  
Shared Decision Making ◽  
Work Experience ◽  
Healthcare Professionals ◽  
Feasibility Trial ◽  
Theory Approach ◽  
Emotional States ◽  
Shared Decision

Background: The majority of existing shared decision making (SDM) models are yet to explicitly account for emotion as an influencing factor to the SDM process. This study aimed to explore the role of parents' and carers' emotional experiences as a concept that has implications for SDM in children and young people's mental health (CYPMH) settings.Methods: A social constructivist grounded theory approach, analyzing data from focus groups (n = 4) and semi-structured interviews (n = 33) with parents and healthcare professionals, was undertaken. Participants were identified and selected at CYPMH sites and through social media platforms or in-person advertising as part of a larger feasibility trial. Interviews and focus groups were audio-recorded and transcribed verbatim. Thematic analysis moved from open to focused coding.Results: The majority of the sample consisted of mothers of adolescent girls. Healthcare professionals had an average of 7.54 (SD = 6.24) years of work experience in CYPMH outpatient capacities. Findings suggested that parents are “expected to, but not always able to” engage in SDM. Themes and subthemes described an affective-appraisal SDM process capturing: (1) views and experiences of SDM, (2) parents' emotional states, (3) the influence of emotions on SDM, and (4) key support systems accessed. The emerging affective-appraisal framework highlighted that negative emotional states hindered parents' active involvement in SDM, and positive emotions encouraged involvement in SDM.Conclusion: The current findings describe an SDM model specific to CYPMH. This new understanding contributes to addressing a possible theory to practice gap opening new challenges and opportunities for academic enquiry.

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