Evaluating the implementation of a multidisciplinary lifestyle-enhancing treatment for severe mentally ill inpatients (MULTI-study)

Abstract

Background There are serious metabolic health problems in especially long-term severe mentally ill inpatients. After studying physical activity, quality of life and psychological determinants to understand the context of the challenge to change lifestyle behaviour, we developed a multidisciplinary lifestyle-enhancing treatment. Results after 18 months showed significant improvements in physical activity, metabolic health, quality of life and psychosocial functioning. Additionally, we wanted to perform a process-evaluation, to support further optimization and valorisation of the treatment. Methods Four categories of determinants (innovation, professional/user, organisational context and socio-political context) were assessed using a questionnaire based on the Dutch validated Measurement Instrument for Determinants of Innovations (questions scored on a 5-point Likert-scale). The questionnaire was sent digitally to 42 healthcare professionals (HP). A reduced version (e.g. excl. organisational context) was administered to patients (N=33) in a semi-structural interview. Preliminary findings Both groups were positive about determinants of the treatment (M=3.88 and M=3.89, respectively), although patients stated it wasn’t easy to participate in the treatment (M=2.18). Determinants of the HP and patients themselves scored positive (M=3.90 and M=3.76, respectively), while organisational context (e.g. staffing, facilities and financial recourses) scored low (M=2.80). Difficulties in getting patients involved, relapse after discharge and a lack of paramedical support and clear policy are main topics in open answers/suggestions. Discussion - Overall, determinants of the treatment and users seems to facilitate treatment-implementation. - Implementation strategies regarding organisational factors are needed. - Detailed analysis of scores and open answers/suggestions will be done to gain more insight into preliminary findings.