Overview of implementation themes
POSITIVE
From the qualitative analysis two overarching themes were constructed that were germane to understanding implementation behaviours within the EMPOWER trial which were Affordances and Perceived Positive Change Processes. Affordances were the engine house of implementation behaviours within the EMPOWER intervention. When applied to interventions like EMPOWER, this describes the processes underpinning how and why participants interacted with the various components of the intervention. Affordances spanned all EMPOWER components including self-monitoring, peer support workers, clinical triaging, wellbeing messages and diary function. The overarching affordances theme compromised of five subthemes which were: Access to Social Connection, Access to Digital, Access to Mental Health Support, the Ability to Gauge Mental Health and Access to Mental Health Information. The affordances framework proposed helped explain the multitude of implementation experiences featured within the qualitative interviews. Affordances helped circle the complex relationships between intervention capabilities and envisioned usage by participants. Affordances could be present at initial contact or developed over sustained engagement and act as a springboard for perceived positive change processes which appeared to explain continued implementation behaviours. These can be seen in Fig. While the affordances subthemes appeared to describe initial implementation experiences, the theme of Perceived Positive Change Processes describes the impact EMPOWER had upon participants from their subjective point of view which described what underpinned sustained implementation behaviours. Four subthemes were constructed which were: Increased Self-Confidence that Patients could Self-manage, Noticing Patterns and Changes, Using EMPOWER as a conversation starter and Appraising Engagement Value.Because qualitative research can yield important insights into adaptations to intervention design, which may be necessary to improve participants’ experiences, we asked participants for suggestions, and their ideas for improvement which are also summarised.
Shows a diagram summarising the relationship between the main themes of Affordances and Perceived Positive Change themes and the subthemes