Stakeholder perspectives on implementation of internet-delivered cognitive behaviour therapy in physical medicine rehabilitation setting using the Consolidated Framework for Implementation Research.

Abstract

Introduction: Despite the growing evidence for the effects of tailored internet-delivered cognitive behaviour therapy (ICBT) programmes for those receiving physical rehabilitation, there is a lack of implementation of these programmes in a clinical or community setting. The aim of the current study was to evaluate barriers and facilitators of implementing an ICBT programme into a physical medicine rehabilitation setting.

Methods: Stakeholders with expertise in physical medicine rehabilitation were recruited (n = 25) including: 16 clinicians, 4 administrators, 3 persons with lived experience, and 2 care partners. Individual semi-structured interviews were conducted based on the domains of the Consolidated Framework for Implementation Research (CFIR). Transcripts were analysed using a positivist approach, using deductive thematic content analysis. Themes were coded based on the domains of CFIR.

Results: Facilitators for implementation primarily fell under intervention characteristics including relative advantage, strong evidence and quality, and design quality. Perceived barriers for implementation were identified in the inner setting including leadership engagement, culture, and available resources.

Conclusions: The results from the current study provide insight on the factors that may contribute towards successful implementation of an ICBT programme in a physical medicine setting.