Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

Figures & data

Table I. Staff characteristics (n = 95).

		Baseline N (%)
Sex^1	Male	25 (27.1)
	Female	67 (72.9)
Age mean (range)		45 (24–65)
Occupation	Care worker/community support worker	33 (34.7)
	Nurse	19 (20.0)
	Social worker	11 (11.6)
	Occupational Therapist	1 (1.1)
	Psychologist	7 (7.4)
	Case manager	11 (11.6)
	Psychiatrist	6 (6.3)
	Other^2	7 (7.4)
Years in profession mean (range)		14 (1–40)

Table II. Description of the implementation program.

Implementation program components	Content	Time
Introductory meeting	- Introducing service managers and staff to the project - Introduction to the concept of SDM - Presentation of facilitators and their role	Baseline
Educating local facilitators	- Written materials, a film and brief introduction to SDM and to their role in supporting the use of DST among all staff in the services. - One day staff training.	Baseline
Educating staff (1 day)	- Seminar on the theoretical concepts and actual knowledge regarding Recovery orientation in practice and SDM. - Introduction of the DST - Practicing SDM with the DST - Discussion on contextual barriers and facilitators	3 weeks
Working with DST	- Users and staff work together with the DST during a period of 6 months.	1–6 months
Continuous facilitation	- Local facilitators engage and support staff in the implementation of the DST in practice	1–6 months
Follow-up seminar 1 (one half day)	- Dialogue with staff providing opportunities to share experiences of working with implementing SDM and to raise questions and issues regarding the digital decision tool. - Discussion on contextual barriers and facilitators	2 months after education
Follow-up seminar 2 (one half day)	- Dialogue with staff providing opportunities to share experiences of working with implementing SDM and to raise questions and issues regarding the digital decision tool. - Discussion on contextual barriers and facilitators	6 months after education

Table III. Blueprint of components of the Process Evaluation framework.

	Description	Process evaluation questions	Data sources
Context	Contextual factors that affect implementation, intervention, mechanism of impact and outcomes	What were the barriers and facilitators to implementing the intervention?	Focus group interviews with staff at 6-month follow-up. Self-reported checklists at 2-month and 6-month follow-up.
Implementation	Implementation process—What is delivered and how is delivery accomplished?	To what extent were all modules in the SDM program (including the support tool) implemented?	Self-reported checklists at 2 and 6-month follow-up.
		To what extent did staff from different services participate?	Self-report checklist after staff education
		What procedures were followed to recruit staff for SDM training?	Self-report checklist after staff education
		What adaptations were made to fit the intervention to the context?	Self-report checklists at 2 and 6-month follow-ups.
Mechanisms of impact	Participants’ response to and interactions with the interventions	Did staff appreciate the DST? Were the staff satisfied with the implementation intervention?	Focus group interviews with staff at 6-month follow-up. Questionnaires to staff^3 at baseline and 6-month follow-up.