Process Evaluations for the Scale-Up of Complex Interventions – a Scoping Review DOI Creative Commons
Lekha Rathod, Martin Heine, Daniel Boateng

et al.

International Journal of Integrated Care, Journal Year: 2024, Volume and Issue: 24, P. 6 - 6

Published: Nov. 8, 2024

Introduction: Complex health interventions (CHIs) are common in (public) and social care practice policy. A process evaluation (PE) is an essential part of designing testing CHIs questions what implemented, the mechanisms change, how context affects implementation. The scale-up challenging heterogeneous, making accompanying PE unique to nature inquiry. Methods: We conducted a scoping review describe current conducting PEs alongside or following CHI. Eight primary data sources were searched extracted on study characteristics, intervention methods used relation PE, stakeholders included. Results: reviewed 10,538 records included 56 studies. Seven thematic areas emerged which being scaled-up. use specific frameworks was rare, outcomes focussed barriers facilitators context; often obtained “once-off” using qualitative quantitative sources. Scale-up strategies reported were: supporting increased coverage, comprehensiveness, institutionalisation; simultaneously. Conclusion: Variations conduct evaluations during phase complex may reflect differences context, conceptual challenges, multi-dimensional scale-up, point engagement with system (e.g., community-level). Ideally, recurrent continuous process, leveraging systems-driven understanding triangulation data, that takes place project inform real-world adaptations (untoward) impact when applicable.

Language: Английский

Recent Advances in Cognitive-Behavioural Therapy for Eating Disorders (CBT-ED) DOI Creative Commons
Glenn Waller, Jessica Beard

Current Psychiatry Reports, Journal Year: 2024, Volume and Issue: 26(7), P. 351 - 358

Published: May 8, 2024

Eating disorders require more effective therapies than are currently available. While cognitive behavioural therapy for eating (CBT-ED) has the most evidence to support its effectiveness, it requires substantial improvement in order enhance reach and outcomes, reduce relapse rates. Recent years have seen a number of noteworthy developments CBT-ED, which summarised this paper.

Language: Английский

Citations

6
A Narrative Review of Early Intervention for Eating Disorders: Barriers and Facilitators DOI Creative Commons
Regan Mills, Lucy Hyam, Ulrike Schmidt

et al.

Adolescent Health Medicine and Therapeutics, Journal Year: 2023, Volume and Issue: Volume 14, P. 217 - 235

Published: Dec. 1, 2023

Abstract: Eating disorders (EDs) are serious psychiatric illnesses that typically develop during adolescence and emerging adulthood. Early intervention is important for improved outcomes young people with EDs, yet help-seeking low individuals often have a significantly protracted start to treatment, suggesting early not well established in the ED field. Previous reviews on facilitators barriers EDs largely cover perceived related patient variables perspectives, whereas clinician-, service-, healthcare system-related less frequently reviewed. The aim of this review synthesize literature regarding patient-, factors. A narrative was conducted by searching relevant peer-reviewed, English-language articles published up until July 2023 PubMed PsychINFO. search two steps. First, key terms were used identify existing meta-analyses EDs. Then, additional added primary secondary research patient/family, clinician, service, facilitators. identified shows that, after overcoming intrinsic, motivational (such as self-stigma, denial, ambivalence), may be met long service waiting lists limited treatment options. Despite these barriers, there ongoing into practice, which aims reach underserved populations facilitate despite high demands shortages trained professionals. Funding services has historically been low, also research-practice gap. This highlights need increased consideration of, funding remove discussions around how make programs scalable sustainable. Keywords: anorexia nervosa, bulimia help-seeking, seeking, mental health

Language: Английский

Citations

12
Improving eating disorder care for underserved groups: a lived experience and quality improvement perspective DOI Creative Commons
Alykhan Asaria

Journal of Eating Disorders, Journal Year: 2025, Volume and Issue: 13(1)

Published: Jan. 22, 2025

Improvements to eating disorder (ED) care are urgently needed in the United Kingdom (UK) and around world. Informed by my lived experiences, independent research, involvement underappreciated field of quality improvement (QI), I have written this article offer ideas on how improve individuals' access experiences ED care. As live UK, QI UK's National Health Service (NHS). However, much article's content can be applied broadly healthcare providers world, as similar improvements internationally. Furthermore, commentary is informed latest international research. In paper, will identify discuss 12 groups individuals whom believe more likely underserved The 'underserved groups' (USGs) follows: [USG. 1] People with longstanding EDs and/or older-age sufferers; 2] Younger children/preadolescents; 3] under-recognised/underappreciated EDs; 4] higher weights; 5] comorbidities; 6] neurodevelopmental conditions (neurodiverse people); 7] Digitally excluded people; 8] Socioeconomically sociogeographically disadvantaged 9] Ethnic/racial minorities; 10] Sexual gender-diverse 11] Males; 12] Caregivers/loved ones. sufferers/caregivers also an group a whole general mental health care, so broader considerations for improving explored future publication; these include stigma, research biases, inadequate clinical monitoring diagnosing, poor-quality treatments, disorganised service transitions, systemic problems/inefficiencies, underfunding/under-resourcing. Specific recommendations USGs 1–12 must considered alongside other issues. Throughout both articles, advocate humanistic model/approach based inexpensive principles compassion, hope, empathy, appreciation (of identity), patience ('CHEAP').

Language: Английский

Citations

0
“FREED instils a bit of hope in the eating disorder community… that things can change.”: an investigation of clinician views on implementation facilitators and challenges from the rapid scaling of the First Episode Rapid Early Intervention for Eating Disorders programme DOI Creative Commons
Lucy Hyam,

Olivia Yeadon-Ray,

Katie Richards

et al.

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: March 26, 2024

Introduction First Episode Rapid Early Intervention for Eating Disorders (FREED) is the leading eating disorder (ED) early intervention model young people. Research has shown that it reduces duration of untreated illness, improves clinical outcomes, and cost savings. However, less known about experience implementing FREED. This study aimed to investigate views experiences adopting, implementing, sustaining FREED from perspective staff. Methods Seven focus groups were conducted involving 26 clinicians. Thematic analysis was used, with Non-Adoption, Abandonment Challenges Scale-up, Spread Sustainability (The NASSS framework) framework being applied organise subthemes determine facilitators barriers. The also used rate complexity themes as either simple (straightforward, predictable, few components), complicated (multiple interrelating or complex (dynamic, unpredictable, not easily divisible into constituent components). Results There 16 identified under seven broader representing each domain framework. Key barriers areas included factors related EDs an illness (e.g., high acuity prevalence), organisational staffing shortages, lack managerial/team support). positive clinician/adopter attitudes, a supportive national network, ability be flexible/adaptable over time. Conclusion appears desirable Wider team managerial support perceived particularly important its successful implementation, network supervision. include issues ED acuity/prevalence. These implementation need managed investment continued expand improve further.

Language: Английский

Citations

3
Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study DOI Creative Commons
Katie Richards, Matthew Phillips, Luiza Grycuk

et al.

Journal of Eating Disorders, Journal Year: 2024, Volume and Issue: 12(1)

Published: April 5, 2024

Abstract Background The First Episode Rapid Early Intervention for Eating Disorders (FREED) service has been shown to reduce the wait care and improve clinical outcomes in initial evaluations. These findings led national scaling of FREED England. To support this scaling, we conducted a mixed method evaluation perceptions experiences clinicians early phases scaling. Normalisation Process Theory (NPT) was used as conceptual lens understand if how becomes embedded routine practice. Methods convergent included 21 semi-structured interviews with from adopter sites 211 surveys administered before, immediately after 3 months training. interview guide survey questions evaluating attitudes towards intervention eating disorders (EDs) NPT mechanisms. Interview data were analysed using an inductive thematic analysis. applied inductively derived themes evaluate domains impacted implementation. Survey multilevel growth models. Results Six 15 subthemes captured barriers facilitators implementation at patient, clinician, service, intervention, wider system levels. interacted mechanisms facilitate or hinder embedding FREED. Overall, enthusiastic positive EDs FREED, largely because expectation improved patient outcomes. This considerable driver uptake Clinicians also had reservations about capacity potential impact on other patients, which, times, barrier its use. training significant improvements that maintained 3-month follow-up. However, negative did not significantly following Conclusions Positive increased enthusiasm engagement model. Features model effective developing commitment capabilities. there aspects which require attention future (e.g., service).

Language: Английский

Citations

2
Early intervention for eating disorders DOI
Regan Mills, Lucy Hyam, Ulrike Schmidt

et al.

Current Opinion in Psychiatry, Journal Year: 2024, Volume and Issue: 37(6), P. 397 - 403

Published: Aug. 15, 2024

Purpose of review Research on early intervention for eating disorders has started to gain traction and examples this in practice are increasing. This summarizes findings over the past 3 years, focusing clinical effectiveness barriers facilitators its implementation. Recent developments can be divided into three broad themes: research that examined efficacy pathways practice, informed understanding target patient groups (via staging models, e.g.), suggested new ways progress intervention, towards becoming a standard part best care. Summary Early have shown promising outcomes viewed positively by patients, clinicians other stakeholders. However, more robust trials their efficacy, cost-effectiveness needed. Additionally, been identified (e.g. delayed help-seeking); must now develop evaluate strategies address these. Finally, models underpinned partly disorders, which require further development, especially than anorexia nervosa.

Language: Английский

Citations

1
Process Evaluations for the Scale-Up of Complex Interventions – a Scoping Review DOI Creative Commons
Lekha Rathod, Martin Heine, Daniel Boateng

et al.

International Journal of Integrated Care, Journal Year: 2024, Volume and Issue: 24, P. 6 - 6

Published: Nov. 8, 2024

Introduction: Complex health interventions (CHIs) are common in (public) and social care practice policy. A process evaluation (PE) is an essential part of designing testing CHIs questions what implemented, the mechanisms change, how context affects implementation. The scale-up challenging heterogeneous, making accompanying PE unique to nature inquiry. Methods: We conducted a scoping review describe current conducting PEs alongside or following CHI. Eight primary data sources were searched extracted on study characteristics, intervention methods used relation PE, stakeholders included. Results: reviewed 10,538 records included 56 studies. Seven thematic areas emerged which being scaled-up. use specific frameworks was rare, outcomes focussed barriers facilitators context; often obtained “once-off” using qualitative quantitative sources. Scale-up strategies reported were: supporting increased coverage, comprehensiveness, institutionalisation; simultaneously. Conclusion: Variations conduct evaluations during phase complex may reflect differences context, conceptual challenges, multi-dimensional scale-up, point engagement with system (e.g., community-level). Ideally, recurrent continuous process, leveraging systems-driven understanding triangulation data, that takes place project inform real-world adaptations (untoward) impact when applicable.

Language: Английский

Citations

1