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Developing, delivering and evaluating primary mental health care : the co-production of a new complex intervention
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Reeve, Joanne L., Cooper, L., Harrington, S., Rosbottom, P. and Watkins, J. (2016) Developing, delivering and evaluating primary mental health care : the co-production of a new complex intervention. BMC Health Services Research, 16 . 470. doi:10.1186/s12913-016-1726-6 ISSN 1472-6963.
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Official URL: http://dx.doi.org/10.1186/s12913-016-1726-6 ...
Abstract
Background:
Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention.
Methods:
The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity’s model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care.
Results:
Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes.
Conclusions:
The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Mental health services, Physicians (General practice) | ||||||||
Journal or Publication Title: | BMC Health Services Research | ||||||||
Publisher: | Biomed central | ||||||||
ISSN: | 1472-6963 | ||||||||
Official Date: | 6 September 2016 | ||||||||
Dates: |
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Volume: | 16 | ||||||||
Article Number: | 470 | ||||||||
DOI: | 10.1186/s12913-016-1726-6 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 31 August 2016 | ||||||||
Date of first compliant Open Access: | 6 September 2016 | ||||||||
Funder: | Great Britain. Department of Health (DoH) | ||||||||
Grant number: | Innovation Excellence and Strategic Development fund grant (2532287 | ||||||||
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