Procedures
RECRUITMENT
Prior to onset of interviews, SA attended weekly team meetings to understand the conduct of the trial and updated SBe on what was happening so that the semi-independent process evaluation team were aware of the context of the trial. EMPOWER participants were invited to take part in interviews to understand their experiences. Service user participants were purposively sampled with reference to gender and intervention engagement. This was chosen because at the two-month point after participants were randomised, concern was raised at team meetings that men were engaging less with the app and peer support, and we felt it would be beneficial to explore these differences qualitatively. Linked to this, it was decided it would be important to speak to participants with differing levels of intervention usage.Participants were first approached by members of the trial team that they had contact with such as the trial managers, peer support workers, clinical triage staff and research assistants. All trial staff were briefed on the study and asked patient participants if they would like to find out more about the study and be contacted by SA or SBe. The study was described as an opportunity to speak to someone about their experiences who was independently evaluating the EMPOWER intervention. All recruitment occurred via trial staff. The staff working on the trial were aware of the wellbeing of participants and sometimes expressed that they felt an interview would be burdensome for participants experiencing high levels of distress which minimised the number of people who could be contacted for an interview.Nonetheless, staff were encouraged to identify people whom they felt were using the app at low levels. During team meetings, it was agreed with trial staff that speaking to 50% of patients still enrolled in the study would generate a variety of viewpoints on the intervention and give adequate information power [The two process evaluation interviewers (SA and SBe) conducted all interviews. They were female, experienced in qualitative methods as part of doctoral research training and had no existing relationships with participants. All participants gave written and informed consent. One-on-One interviews with UK-based participants were conducted face-to-face with patients (n = 12) and a carer (n = 1) and interviews with UK-based staff (n = 5) were conducted by SBe as part of her doctoral training in clinical psychology. Interviews with Australian patient participants (n = 4) and a mental health staff member (n = 1) were conducted by SA over the telephone. Interviews with UK carer and patient participants were conducted in people’s homes. Mental health staff were interviewed in their place of work. SA and SBe took notes during interviews. Everyone was interviewed during trial participation to minimise retrospective recall biases or loss of recall detail. Interviews were conducted between 14/11/2018 and 18/06/2019, and all of these dates were prior to participants no longer having access to the intervention at the end of June 2019. All interviews were audio-recorded and then transcribed verbatim, participant details were anonymised, and people referred to by a pseudonym. Transcripts were not returned to participants due to time limitations.Further information on the development of the pilot tested interview schedules (and actual copies of the schedules) can be seen in the pre-published protocol [
The service user interview schedule covered:
Experiences of using EMPOWER.Experiences of implementing EMPOWER in the context of daily life.Experiences of intervention components.Experiences of data sharing.Suggestions for improvement.The mental health staff interview schedule covered:
Experiences of supporting a patient taking part in EMPOWER.Experiences of interacting with EMPOWER in clinical practice.Experiences of data sharing.Suggestions for improvement.The carer interview schedule covered:
Experiences of supporting a patient taking part in EMPOWER.Experiences of data sharing.Suggestions for improvement.