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      Perceived Acceptability and Experiences of a Digital Psychoeducation and Peer Support Intervention (COPe-support): Interview Study With Carers Supporting Individuals With Psychosis

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          Abstract

          Background

          Web-based mental health interventions offer a novel, accessible, and self-paced approach to care delivery to family carers (ie, relatives and close friends who support a loved one with psychosis). We coproduced COPe-support (Carers fOr People with Psychosis e-support), a psychoeducational intervention delivered via an enriched web-based learning environment with network support from professionals and peers. In addition to the rigorous investigation of the effectiveness of COPe-support on the well-being of carers and mental health outcomes, it is imperative to understand the experiences of using the web-based intervention by carers and its associated web-based implementation and facilitation strategies.

          Objective

          This study aims to explore the experiences of carers and perceived acceptability of COPe-support and its different components, how carers found engagement with COPe-support affected their own well-being and caregiving, and the ideas of carers for improving COPe-support and its delivery to inform any future wider implementation.

          Methods

          We conducted a qualitative study, individually interviewing 35 carers, following their use of COPe-support for 8 months through a web-based, randomized controlled trial across England. A semistructured guide with open-ended questions was used to explore the experiences of carers and perceived acceptability of the intervention and their ideas to improve the provision. All interviews were conducted remotely through mobile phones or internet communication media, audio recorded and transcribed verbatim. We used a thematic analysis framework to analyze the data.

          Results

          Three key themes were identified: remote, flexible, and personalized support; impacts on well-being and outlook on caregiving; and future implementation and integration with existing services. Overall, carers found COPe-support a flexible source of knowledge and support from professionals and peers that they could personalize to suit their own needs and convenience. Participants described gaining self-confidence, hope, and a sense of connectivity with others in a similar situation, which helped ameliorate isolation and perceived stigma. Most importantly, COPe-support promoted self-care among the carers themselves. Participants’ experiences, use, and activity on COPe-support varied greatly and differed among carers of various ages and levels of computer literacy.

          Conclusions

          Nearly all participants had a positive experience with COPe-support and supported its wider implementation as a beneficial adjunctive support resource for carers in the future. Any future scale-up of such an intervention needs to consider feedback from carers and suggestions for further improvement. These included having more graphics and audiovisual content materials, improving the navigation, and building in more interactional and customization options to suit various user styles, such as emoji reactions, live web-based chat, opting in and out of updates, and choosing the frequency of reminders. To ensure successful implementation, we should also consider factors pertinent to reaching more carers and integrating the web-based resources with other conventional services.

          Trial Registration

          International Standard Randomized Controlled Trial Number (ISRCTN) 89563420; https://www.isrctn.com/ISRCTN89563420

          International Registered Report Identifier (IRRID)

          RR2-10.1186/s12888-020-02528-w

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          Most cited references44

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          How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability

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            Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development

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              Normalisation process theory: a framework for developing, evaluating and implementing complex interventions

              Background The past decade has seen considerable interest in the development and evaluation of complex interventions to improve health. Such interventions can only have a significant impact on health and health care if they are shown to be effective when tested, are capable of being widely implemented and can be normalised into routine practice. To date, there is still a problematic gap between research and implementation. The Normalisation Process Theory (NPT) addresses the factors needed for successful implementation and integration of interventions into routine work (normalisation). Discussion In this paper, we suggest that the NPT can act as a sensitising tool, enabling researchers to think through issues of implementation while designing a complex intervention and its evaluation. The need to ensure trial procedures that are feasible and compatible with clinical practice is not limited to trials of complex interventions, and NPT may improve trial design by highlighting potential problems with recruitment or data collection, as well as ensuring the intervention has good implementation potential. Summary The NPT is a new theory which offers trialists a consistent framework that can be used to describe, assess and enhance implementation potential. We encourage trialists to consider using it in their next trial.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                February 2022
                2 February 2022
                : 24
                : 2
                : e27781
                Affiliations
                [1 ] Population Health Research Institute St George's, University of London London United Kingdom
                [2 ] School of Psychology & Clinical Language Sciences University of Reading Reading United Kingdom
                [3 ] Locum GP London United Kingdom
                [4 ] Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
                [5 ] School of Health Sciences City, University of London London United Kingdom
                [6 ] Centre for Technology in Education St George's, University of London London United Kingdom
                [7 ] Imperial Clinical Trials Unit, School of Public Health Imperial College London London United Kingdom
                Author notes
                Corresponding Author: Jacqueline Sin jacqueline.sin@ 123456city.ac.uk
                Author information
                https://orcid.org/0000-0002-0426-2388
                https://orcid.org/0000-0001-7519-7686
                https://orcid.org/0000-0002-2213-1736
                https://orcid.org/0000-0001-7745-6696
                https://orcid.org/0000-0002-6998-5659
                https://orcid.org/0000-0002-9686-2232
                https://orcid.org/0000-0003-4170-2925
                https://orcid.org/0000-0002-0080-1065
                https://orcid.org/0000-0002-4060-2394
                https://orcid.org/0000-0003-0590-7165
                Article
                v24i2e27781
                10.2196/27781
                8851336
                35107439
                3aa2413e-2f38-42ea-afc3-6abc3e350054
                ©Rachel Batchelor, Sarah Gulshan, Halpana Shritharan, Elen Williams, Claire Henderson, Steve Gillard, Luke A Woodham, Victoria Cornelius, Jack Elkes, Jacqueline Sin. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 02.02.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 21 February 2021
                : 10 May 2021
                : 21 May 2021
                : 30 November 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                ehealth,family carers,qualitative research,psychosis,peer support,web-based psychoeducation,mobile phone

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