IMPlementation of A Relatives Toolkit (IMPART study): examining the critical success factors, barriers and facilitators to implementation of an online supported self-management intervention in the NHS

Lobban F, Appelbe D, Appleton V, Aref-Adib G, Barraclough J, Billsborough J, Fisher NR, Foster S, Gill B, Glentworth D, Harrop C, Johnson S, Jones SH, Kovacs TZ, Lewis E, Mezes B, Morton C, Murray E, O’Hanlon P, Pinfold V, Rycroft-Malone J, Siddle R, Smith J, Sutton CJ, Viglienghi P, Walker A, Wintermeyer C
Record ID 32016000661
Authors' objectives: Relatives of people with psychosis provide a large amount of vital unpaid care, but at huge personal cost in terms of high levels of distress, and significant practical, financial and emotional burden. Currently relatives do not receive adequate support or information, despite this being recommended by UK government guidelines. The Relatives Education And Coping Toolkit (REACT) has been developed in response to this need, and is an online supported self-management toolkit for relatives of people with recent onset psychosis. REACT is recovery focussed, co-produced with relatives, and designed to provide relatives with the information and skills they need to support someone with psychosis. REACT has a modular format with the content divided into 13 sections which can be used flexibly depending on individual needs. Each relative is supported to use the toolkit via email / telephone contact with a member of the clinical team. REACT has already been shown to be effective in reducing relatives distress and increasing their sense of being supported (22). The challenge now is how to ensure this intervention is made widely available to relatives. Unfortunately many evidence based interventions do not reach frontline clinical services. There is an urgent need to understand how to close the gap between evidence and practice. In this study we aim to investigate the factors which impact on how the REACT toolkit is implemented in the NHS, in order to produce a national Implementation Plan for all NHS Trusts. First we generate hypotheses about the factors which are likely to impact on implementation of REACT, based on existing theory, our feasibility data, and clinical expertise within the Trusts. We will then introduce REACT to 6 NHS Trusts on a phased basis over 18 months (2 sites at a time), closely examining how REACT is implemented and using information gathered to draft and modify an Implementation Plan. Data collection in each trust is guided by a Stakeholder Group including service users, relatives, clinicians, and senior managers. Lastly, we will finalise the Implementation Plan based on the information collected. We will examine how the findings of our research can be generalised to other self-management interventions in the NHS. The study is good value for money. First it promotes an inexpensive way to ensure relatives are well supported and able to continue their caring role, which saves the NHS a lot of money. Secondly, the outputs will have a broad relevance in the NHS. Supported self-management interventions are becoming an increasingly popular way to deliver cost effective healthcare and potentially improve access, but how these approaches get delivered in routine clinical practice is poorly understood. The knowledge gained from this study can help ensure potential benefits from these innovations are realised. The Research Team includes: senior clinicians and service leads within EIS; a relative of someone with psychosis; a user-focussed research charity; clinical academics with a track record of evaluating new mental health interventions in the NHS; and an expert in implementation science. Many of the team have worked together previously on developing and evaluating the REACT intervention, with additional members added for relevant methodological expertise around implementation and delivery.
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Bipolar Disorder
  • Health Education
  • Caregivers
  • Mental Health
  • Mental Health Services
  • Self-Management
  • Family
  • Psychotic Disorders
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
Contact Email:
Copyright: Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.