| 1. |
- Blomberg, Oscar, et al.
(författare)
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Adaptation of a guided low-intensity behavioral activation intervention for people with dementia in Sweden : a qualitative study exploring the needs and preferences of key stakeholders
- 2024
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Ingår i: BMC Geriatrics. - : Springer. - 1471-2318. ; 24:113
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDespite depression being prevalent in people with dementia, contributing to negative health outcomes and placing increased burden on individuals and family members, access to psychological interventions is limited. A potential solution is guided low-intensity behavioral activation, supported by informal caregivers and guided by healthcare professionals. However, it is necessary to adapt interventions to meet the needs and preferences of key stakeholders to enhance acceptability and relevance. Study objectives were to: (1) explore needs and preferences concerning the content and delivery model of the guided low-intensity behavioral activation intervention; and (2) adapt the intervention to ensure cultural appropriateness, relevancy, and acceptability to people with dementia and their caregivers in Sweden.MethodsSemi-structured interviews and focus group discussions were conducted with key stakeholders, including healthcare professionals (n = 18), community stakeholders (n = 7), people with dementia (n = 8), and informal caregivers (n = 19). A draft of the written low-intensity behavioral activation intervention and a description of the proposed intervention delivery model were provided to participants. Open-ended questions explored the perceived relevance of the intervention, alongside needs and preferences concerning content and delivery. A manifest content analysis approach was adopted.ResultsContent analysis resulted in three categories: Content, Delivery procedures, and Illness trajectory. Results highlighted a need to consider the intervention Content via increased cultural adaptation to the Swedish context, and increasing the inclusiveness of intervention content. Delivery procedures were identified as needing to be flexible given the unpredictable nature of caring for people with dementia, with the provision of additional guidance to informal caregivers supporting the intervention. Illness trajectory was viewed as essential to consider, with the intervention regarded as suitable for those early in the dementia trajectory, alongside a need to reduce workbook text to minimize burden given dementia symptomology.ConclusionsThe intervention and proposed delivery model were generally well received by all stakeholders. We were able to identify key adaptations to enhance cultural appropriateness, relevancy, and acceptability for a currently neglected population. Results will inform a feasibility study to explore the feasibility and acceptability of the intervention and study procedures to inform the design of a future superiority randomized controlled trial.
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| 2. |
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| 3. |
- Brantnell, Anders, 1983-, et al.
(författare)
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An inductive exploration of the implementation knowledge of research funders
- 2019
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Ingår i: Health Research Policy and Systems. - : Springer Science and Business Media LLC. - 1478-4505. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare research funders may undertake various roles to facilitate implementation of research findings. Their ability to enact such roles depends on several factors, knowledge of implementation being one essential requirement. However, previous studies do not assess the type or level of knowledge about implementation that research funders possess. This paper therefore presents findings from a qualitative, inductive study of the implementation knowledge of research funders. Three aspects of this knowledge are explored, namely how research funders define implementation, their level of self-assessed implementation knowledge and the factors influencing their self-assessment of implementation knowledge.Methods: Research funders (n = 18) were purposefully selected from a sample of research funding organisations in Sweden (n = 10). In-depth semi-structured interviews were conducted, recorded and transcribed verbatim. An inductive method using a systematic coding procedure was employed to derive the findings.Results: The research funders defined implementation as either an outcome or a process, with the majority believing that implementation of healthcare research results demands a process, although its complexity varied in the research funders’ view. They perceived their own level of implementation knowledge as either limited or substantial, with a majority regarding it as limited. Clinical research experience, clinical experience and task relevance were singled out as the clearest factors affecting the self-assessment of their own implementation knowledge.Conclusions: This study, the first to focus on implementation knowledge of research funders, demonstrates that they are a category of policy-makers who may possess knowledge, based on their previous professional experience, that is comparable to some important findings from implementation research. Consequently, the findings not only pinpoint the relevance of professional experience, but also reveal a lack of awareness and knowledge of the results of implementation research among research funders in charge of healthcare research.
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| 4. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Barriers and facilitators to the implementation of additive manufacturing in cardiology : A qualitative study
- 2022
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Ingår i: Annals of 3D Printed Medicine. - : Elsevier. - 2666-9641. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Additive manufacturing (AM) is a fast-developing technology with possible applications in car-diology. Existing research has identified two general factors that can influence implementing AM in cardiol-ogy: economics and technology.Objective: In this study we aimed to identify barriers and facilitators to implementing AM in cardiology.Methods: We conducted a multiple case study of two Swedish cardiac surgery departments representingimplementers and non-implementers of AM. We interviewed key stakeholders (n=8) who had been or wereinvolved in implementing AM in cardiology or AM in general at the hospitals: cardiologists, physicians work-ing with AM but not specialized in cardiology such as radiologists, company representatives, and individualsinvolved in the 3D-printing facilities. A combination of an inductive and deductive approach was used to ana-lyze the interviews.Results: Several barriers and facilitators influenced implementing AM in cardiology. Most barriers (n=4) wererelated to innovation factors, whereas most facilitators (n=4) were related to healthcare professionals. No barriers and facilitators were related to patients.Conclusion: Our findings show that AM in cardiology is in its very early phases in both hospitals and mostlythe work of a few individuals. In the two hospitals studied, there were some unique differences in terms ofbarriers that could explain the low level of implementation. These barriers could be important to addresswhen supporting implementation of AM at hospitals where AM use is still low.
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| 5. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Barriers to and Facilitators of the Implementation of Digital Mental Health Interventions as Perceived by Primary Care Decision Makers : Content Analysis of Structured Open-Ended Survey Data
- 2023
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Ingår i: JMIR Human Factors. - : JMIR Publications. - 2292-9495. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Digital mental health represents a way to increase access to evidence-based psychological support. However, the implementation of digital mental health in routine health care practice is limited, with few studies focusing on implementation. Accordingly, there is a need to better understand the barriers to and facilitators of implementing digital mental health. Existing studies have mainly focused on the viewpoints of patients and health professionals. Currently, there are few studies about barriers and facilitators from the perspective of primary care decision makers, that is, the persons responsible for deciding whether a given digital mental health intervention should be implemented in a primary care organization.Objective: The objectives were to identify and describe barriers to and facilitators of the implementation of digital mental health as perceived by primary care decision makers, evaluate the relative importance of different barriers and facilitators, and compare barriers and facilitators reported by primary care decision makers who have versus have not implemented digital mental health interventions.Methods: A web-based self-report survey was conducted with primary care decision makers responsible for the implementation of digital mental health in primary care organizations in Sweden. Answers to 2 open-ended questions about barriers and facilitators were analyzed through summative and deductive content analysis.Results: The survey was completed by 284 primary care decision makers—59 (20.8%) decision makers representing implementers (ie, organizations that offered digital mental health interventions) and 225 (79.2%) respondents representing nonimplementers (ie, organizations that did not offer digital mental health interventions). Overall, 90% (53/59) of the implementers and 98.7% (222/225) of the nonimplementers identified barriers, and 97% (57/59) of the implementers and 93.3% (210/225) of the nonimplementers identified facilitators. Altogether, 29 barriers and 20 facilitators of implementation were identified related to guidelines; patients; health professionals; incentives and resources; capacity for organizational change; and social, political, and legal factors. The most prevalent barriers were related to incentives and resources, whereas the most prevalent facilitators were related to the capacity for organizational change.Conclusions: A number of barriers and facilitators were identified that could influence the implementation of digital mental health from the perspective of primary care decision makers. Implementers and nonimplementers identified many common barriers and facilitators, but they differ in terms of certain barriers and facilitators. Common and differing barriers and facilitators identified by implementers and nonimplementers may be important to address when planning for the implementation of digital mental health interventions. For instance, financial incentives and disincentives (eg, increased costs) are the most frequently mentioned barrier and facilitator, respectively, by nonimplementers, but not by implementers. One way to facilitate implementation could be to provide more information to nonimplementers about the actual costs related to the implementation of digital mental health.
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| 6. |
- Brantnell, Anders, 1983-
(författare)
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Exploitation of University-Based Healthcare Innovations : The Behaviors of Three Key Actors and Influencing Factors
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Large resources are invested in healthcare research, but despite this there is a wide gap between research knowledge and healthcare practice. Implementation researchers have addressed this gap, focusing mostly on the role of healthcare practitioners. However, a narrow focus on implementation does not take into consideration the preceding stages and the roles of different actors during the whole innovation process, which starts from research and ends with implementation. The aim of this thesis is to examine the behaviors of three key actors during an innovation process and to explore the influence of selected contextual factors on their behavior.Study I (n=10 funders) identifies several facilitative roles for funders and suggests that implementation risks becoming no one’s responsibility as the funders identify six different actors responsible for implementation, the majority of whom embody a collective or an organization. Study II finds that the implementation knowledge of Swedish funding managers (n=18) is mostly based on experience-based knowledge. The majority of the funding managers define implementation as a process and express limited knowledge of implementation. The findings of Study III (n=4 innovation cases) show that the roles and involvement of academic inventors and ISAs (innovation-supporting actors) are more connected to intellectual property (IP) nature than to intellectual property rights (IPR) ownership. Study IV (n=4 innovation cases) identifies three different logics that influence the behavior of academic inventors: market, academic and care logics. A pattern emerges where the behavior of academic inventors is guided by a unique logic and there is no interaction between logics, despite the existence of multiple logics. The individual strategies to handle multiple logics coincide with the influence of logics. In addition, IP nature, distinguishing between high-tech and low-tech innovations, is connected to the influence of institutional logics: low-tech connected to the care logic and high-tech connected to the market logic.This thesis has three main theoretical and practical implications relevant for practitioners, policymakers and researchers. First, implementation responsibility is an important issue to study and discuss, because without clearly defined responsibilities and management of responsibilities, responsibility might become no one’s responsibility. Second, the finding that experience-based implementation knowledge contributes heavily to policymakers’ knowledge encourages further studies and discussions regarding this relatively neglected issue. Third, the importance of IP nature in shaping innovation processes should be considered and further examined, not only as a factor influencing inventors and ISAs’ roles and involvement, but also as influencing the prevalence of different institutional logics. Further, the relevance of a distinction between low-tech and high-tech IP should be reflected on.
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| 7. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Following unique logics despite institutional complexity : An inductive study of academic inventors and institutional logics
- 2020
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Ingår i: European Management Journal. - : Elsevier BV. - 0263-2373 .- 1873-5681. ; 38:5, s. 684-697
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Tidskriftsartikel (refereegranskat)abstract
- This paper examines how institutional complexity, due to the availability of multiple logics, influences the behavior of academic inventors during an innovation process. Based on four case studies of medical technology innovations, this paper identifies three logics influencing academic inventors’ behavior: academic, market, and care logics. We identify several patterns that characterize the practices of academic inventors in a context with multiple institutional logics. Despite the availability of multiple logics, we observe a strong pattern of academic inventors predominantly following the market or the care logic. As for the influence of multiple logics, we find very limited interaction between logics (i.e., reinforcing, complementary and conflicting interaction), with the prevalent pattern being “no interaction” between institutional logics. Thus, instead of following several logics, academic inventors’ specific practices are mostly guided by a “unique” logic. This influence of logics leads to a clear pattern of “dominant” influence on behavior, reflected in individual strategies of “entrenching,” that is, a strategy based on building one’s behavior on a “unique” logic. However, the same available logics can also generate "aligned" influence, entailing behavior guided by several logics. But this occurs only if the academic inventor faces uncertainty regarding the exploitation of the intellectual property. With these findings, we add to the ongoing discussion concerning institutional complexity and individual behavior by elucidating in detail how institutional complexity can entail behavior guided by “unique” logics.
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| 8. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Implementation of medical technology in management and engineering studies : A systematic literature review and future research agenda
- 2024
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Ingår i: Technology in society. - : Elsevier. - 0160-791X .- 1879-3274. ; 77
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Forskningsöversikt (refereegranskat)abstract
- Medical technology is an important part of healthcare and society, and new solutions are needed to meet the demands of aging population and prevalence of chronic diseases. During the last decade considerable technical progression has taken place but implementation of these new solutions is still cumbersome. This study reviews the current state of research within management and engineering studies concerning implementation of medical technology and identifies avenues for further research. A systematic search with keywords such as implementation and medical technology identified 2809 hits of which only ten papers were about implementation of medical technology. This review provides four contributions to research and management: (1) the findings show that there is no field that can be called implementation of medical technology within management and engineering studies, (2) there is no specific journal that publishes research on the topic, (3) majority of the papers are opinion articles and qualitative case studies and (4) many reported barriers to implementation relate to technology. In order to address the complex task of implementing medical technology, management scholars to a larger extent need to acknowledge and study aspects that go beyond technology.
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| 9. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Psychosocial care via internet, a mode to achieve improved patient care at a lower cost?
- 2011
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Konferensbidrag (refereegranskat)abstract
- The primary research objective of the U-CARE Program is to evaluate the clinical efficacy and cost-effectiveness of Internet-based self-managed programs of psychosocial care to patients and significant others. To reach this we have constructed an Internet-based platform. In order to plan for implementation we have carried out a stakeholder analysis and identified possible implementation strategies
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| 10. |
- Brantnell, Anders, 1983-, et al.
(författare)
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Research funders’ roles and perceived responsibilities in relation to the implementation of clinical research results: a multiple case study of Swedish research funders
- 2015
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundImplementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funders in relation to implementation and their views on responsibilities in implementation.FindingsTen cases were studied and compared using semi-structured interviews. In addition, websites and key documents were reviewed. Eight facilitative roles for research funders in relation to the implementation of clinical research results were identified. Three of them were common for several funders: “Advocacy work,” “Monitoring implementation outcomes,” and “Dissemination of knowledge.” Moreover, the research funders identified six different actors responsible for implementation, five of which belonged to the healthcare setting. Collective and organizational responsibilities were the most common forms of responsibilities among the identified actors responsible for implementation.ConclusionsThe roles commonly identified by the Swedish funders, “Advocacy work,” “Monitoring implementation outcomes,” and “Dissemination of knowledge,” seem feasible facilitative roles in relation to the implementation of clinical research results. However, many actors identified as responsible for implementation together with the fact that collective and organizational responsibilities were the most common forms of responsibilities entail a risk of implementation becoming no one’s responsibility.
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