TY - JOUR
AU - L. Gask
AU - P. Bower
AU - K. Lovell
AU - D. Escott
AU - J. Archer
AU - S. Gilbody
AU - A. J. Lankshear
AU - A. E. Simpson
AU - D. A. Richards
A1 - 
AB - 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.
BT - Implementation science : IS
C5 - General Literature
CY - England
DO - 10.1186/1748-5908-5-15
JF - Implementation science : IS
N2 - 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.
PP - England
PY - 2010
SN - 1748-5908; 1748-5908
SP - 15
T1 - What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
T2 - Implementation science : IS
TI - What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
U1 - General Literature
U2 - 20181163
U3 - 10.1186/1748-5908-5-15
VL - 5
VO - 1748-5908; 1748-5908
Y1 - 2010
ER -