Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II
Background Despite the efficacy of lifestyle interventions for the physical and mental health of people with mental illness, there is little change in clinical care. Understanding barriers and facilitators of implementation can help interpret intervention effectiveness and aid implementation. This c...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-07-01
|
| Series: | Implementation Research and Practice |
| Online Access: | https://doi.org/10.1177/26334895251351663 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850083551907676160 |
|---|---|
| author | Myrthe M.E. van Schothorst Natascha M. den Bleijker Peter N. van Harten Nanne K. De Vries Jeroen Deenik |
| author_facet | Myrthe M.E. van Schothorst Natascha M. den Bleijker Peter N. van Harten Nanne K. De Vries Jeroen Deenik |
| author_sort | Myrthe M.E. van Schothorst |
| collection | DOAJ |
| description | Background Despite the efficacy of lifestyle interventions for the physical and mental health of people with mental illness, there is little change in clinical care. Understanding barriers and facilitators of implementation can help interpret intervention effectiveness and aid implementation. This cross-sectional study identifies barriers and facilitators before implementing a multidisciplinary lifestyle approach in the treatment of inpatients with mental illness (MULTI+). Additionally, we analyze associations between barriers and facilitators, and recipients’ health and demographic characteristics. Method This study used baseline data from an open cohort stepped wedge cluster randomized trial. The Measurement Instrument for Determinants of Innovations was used to investigate barriers and facilitators associated with the innovation (MULTI+), user (recipients and deliverers), and organization. Data was collected through semi-structured interviews for recipients and an online survey for deliverers. We explored associations between barriers and facilitators, and recipients’ health and demographic characteristics through multiple regression models. Results We included 134 recipients and 125 deliverers. Perceived barriers to implementing MULTI+ included complexity, incomplete information, and incompatibility with current treatment. Recipients and deliverers reported personal barriers, including a lack of personal benefits, potential drawbacks, and insufficient knowledge. Facilitators such as the recognized importance of lifestyle-focused care, social support, and organizational commitment could enhance implementation. Being hospitalized for more than a year was negatively associated with determinants such as compatibility, patient relevance, and satisfaction (range between β = −.25 and β = −.45). Regression models indicated few other associations. Suggestions to address barriers were made. Conclusions This study is one of the first to analyze barriers and facilitators before the large-scale implementation of a multicomponent lifestyle-focused approach in mental healthcare. Recipients and deliverers experience barriers and facilitators across all domains. Addressing these factors through patient-level tailoring, structured training, the use of champions, and sustained organizational support may enhance implementation and sustainability. Trial Registration ClinicalTrials.gov registration. Identifier: NCT04922749. Retrospectively registered 3rd of June 2021. |
| format | Article |
| id | doaj-art-72039ff61a4f4a4293372e3c75daf609 |
| institution | DOAJ |
| issn | 2633-4895 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Implementation Research and Practice |
| spelling | doaj-art-72039ff61a4f4a4293372e3c75daf6092025-08-20T02:44:16ZengSAGE PublishingImplementation Research and Practice2633-48952025-07-01610.1177/26334895251351663Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study IIMyrthe M.E. van Schothorst0Natascha M. den Bleijker1Peter N. van Harten2Nanne K. De Vries3Jeroen Deenik4 Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands Faculty of Health, Medicine, and Life Sciences, CAPHRI, Maastricht University, Maastricht, the Netherlands School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the NetherlandsBackground Despite the efficacy of lifestyle interventions for the physical and mental health of people with mental illness, there is little change in clinical care. Understanding barriers and facilitators of implementation can help interpret intervention effectiveness and aid implementation. This cross-sectional study identifies barriers and facilitators before implementing a multidisciplinary lifestyle approach in the treatment of inpatients with mental illness (MULTI+). Additionally, we analyze associations between barriers and facilitators, and recipients’ health and demographic characteristics. Method This study used baseline data from an open cohort stepped wedge cluster randomized trial. The Measurement Instrument for Determinants of Innovations was used to investigate barriers and facilitators associated with the innovation (MULTI+), user (recipients and deliverers), and organization. Data was collected through semi-structured interviews for recipients and an online survey for deliverers. We explored associations between barriers and facilitators, and recipients’ health and demographic characteristics through multiple regression models. Results We included 134 recipients and 125 deliverers. Perceived barriers to implementing MULTI+ included complexity, incomplete information, and incompatibility with current treatment. Recipients and deliverers reported personal barriers, including a lack of personal benefits, potential drawbacks, and insufficient knowledge. Facilitators such as the recognized importance of lifestyle-focused care, social support, and organizational commitment could enhance implementation. Being hospitalized for more than a year was negatively associated with determinants such as compatibility, patient relevance, and satisfaction (range between β = −.25 and β = −.45). Regression models indicated few other associations. Suggestions to address barriers were made. Conclusions This study is one of the first to analyze barriers and facilitators before the large-scale implementation of a multicomponent lifestyle-focused approach in mental healthcare. Recipients and deliverers experience barriers and facilitators across all domains. Addressing these factors through patient-level tailoring, structured training, the use of champions, and sustained organizational support may enhance implementation and sustainability. Trial Registration ClinicalTrials.gov registration. Identifier: NCT04922749. Retrospectively registered 3rd of June 2021.https://doi.org/10.1177/26334895251351663 |
| spellingShingle | Myrthe M.E. van Schothorst Natascha M. den Bleijker Peter N. van Harten Nanne K. De Vries Jeroen Deenik Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II Implementation Research and Practice |
| title | Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II |
| title_full | Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II |
| title_fullStr | Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II |
| title_full_unstemmed | Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II |
| title_short | Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II |
| title_sort | barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness multi the multi study ii |
| url | https://doi.org/10.1177/26334895251351663 |
| work_keys_str_mv | AT myrthemevanschothorst barriersandfacilitatorsofinpatientsandhealthcareprofessionalspriortotheimplementationofamultidisciplinarylifestylefocusedapproachinthetreatmentofinpatientswithmentalillnessmultithemultistudyii AT nataschamdenbleijker barriersandfacilitatorsofinpatientsandhealthcareprofessionalspriortotheimplementationofamultidisciplinarylifestylefocusedapproachinthetreatmentofinpatientswithmentalillnessmultithemultistudyii AT peternvanharten barriersandfacilitatorsofinpatientsandhealthcareprofessionalspriortotheimplementationofamultidisciplinarylifestylefocusedapproachinthetreatmentofinpatientswithmentalillnessmultithemultistudyii AT nannekdevries barriersandfacilitatorsofinpatientsandhealthcareprofessionalspriortotheimplementationofamultidisciplinarylifestylefocusedapproachinthetreatmentofinpatientswithmentalillnessmultithemultistudyii AT jeroendeenik barriersandfacilitatorsofinpatientsandhealthcareprofessionalspriortotheimplementationofamultidisciplinarylifestylefocusedapproachinthetreatmentofinpatientswithmentalillnessmultithemultistudyii |