| 1. |
- Blomberg, Oscar, et al.
(author)
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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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In: BMC Geriatrics. - : Springer. - 1471-2318. ; 24:113
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Journal article (peer-reviewed)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.
(author)
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An inductive exploration of the implementation knowledge of research funders
- 2019
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In: Health Research Policy and Systems. - : Springer Science and Business Media LLC. - 1478-4505. ; 17
-
Journal article (peer-reviewed)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.
(author)
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Barriers and facilitators to the implementation of additive manufacturing in cardiology : A qualitative study
- 2022
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In: Annals of 3D Printed Medicine. - : Elsevier. - 2666-9641. ; 7
-
Journal article (peer-reviewed)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.
(author)
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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
-
In: JMIR Human Factors. - : JMIR Publications. - 2292-9495. ; 10
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Journal article (peer-reviewed)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-
(author)
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Exploitation of University-Based Healthcare Innovations : The Behaviors of Three Key Actors and Influencing Factors
- 2017
-
Doctoral thesis (other academic/artistic)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.
(author)
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Following unique logics despite institutional complexity : An inductive study of academic inventors and institutional logics
- 2020
-
In: European Management Journal. - : Elsevier BV. - 0263-2373 .- 1873-5681. ; 38:5, s. 684-697
-
Journal article (peer-reviewed)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.
(author)
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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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In: Technology in society. - : Elsevier. - 0160-791X .- 1879-3274. ; 77
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Research review (peer-reviewed)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.
(author)
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Psychosocial care via internet, a mode to achieve improved patient care at a lower cost?
- 2011
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Conference paper (peer-reviewed)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.
(author)
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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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In: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Journal article (peer-reviewed)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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| 11. |
- Brantnell, Anders, 1983-, et al.
(author)
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Testbed for Material and Additive Manufacturing : Needs Analysis and Benchmarking
- 2022
-
Reports (other academic/artistic)abstract
- The manufacturing industry is facing a radical transformation due to digitization of production, demands on sustainable production, and possibilities of additive manufacturing (AM). AM, an alternative to mechanical manufacturing, provides several benefits such as rapid prototyping and low environmental impact. AM offers an opportunity for companies to improve their competitive conditions and value offerings while contributing to sustainable development. However, AM also poses challenges for companies, especially for small- and medium-sized enterprises (SMEs) as these companies often lack the financial resources and expertise to use new manufacturing methods. Testbeds are one way to support companies and accelerate change towards AM. This report builds on previous investigations concerning testbeds and AM and explores the possibilities and conditions to establish a testbed with a focus on AM in the Uppsala Region. This report builds on site visits and interviews with ten existing testbeds and site visits and interviews with 14 companies. The testbeds were spread around the country, and the companies were centered on the Uppsala Region.The findings are divided into two clusters: companies and testbeds. Altogether, nine companies either manufactured AM components or AM powder. All 14 companies had experience using AM, which is a clear indication that all these companies are early adopters or potential early adopters of AM. The companies that did not use AM (non-adopters) considered AM to be a promising technology but believed that AM did not fit with their current operations. The non-adopters believed AM was best suited for R&D, where proof of concepts and prototypes are developed and explored, which implies low technical maturity. Most the companies saw AM as a possibility for their operations. Non-adopters perceived AM as a possible complement to traditional manufacturing. Several non-adopters noted that they would adopt AM if customers requested it. Many non-adopters had difficulties identifying a business case for AM. In total, seven of the 14 companies had no experience with testbeds. Many companies envisioned a physical facility placed preferably near Uppsala and considered that a testbed could be helpful with material development. Many of the companies preferred a pay per use price model for the testbed. Furthermore, many of the companies were not willing to invest in creation of a testbed, but they were interested in using a testbed if available.Of the ten testbeds investigated, six integrate AM in their operations. Irrespective of whether the testbeds used AM, the establishment of the testbeds can be seen as an incremental trial and error process, which takes time and often starts with common projects. The path to establishing a formal testbed varied across the testbeds, but all the testbeds were developed based on the needs of their stakeholders such as academia or industry. Most of the testbeds needed to secure financing. Many of the testbeds initially received public funding, and these funds were used to establish facilities and set up an organization. The main challenge lies in having long-term financing covering running costs of rent, maintenance, human resources, and continuous investments. In addition to pay per use fees, a base funding originating (e.g., from member organizations) is crucial for long-term survival. The testbeds had difficulties estimating capacity use of the facilities, but all concluded the use is not yet 100%, so there are possibilities to increase the use of the facilities. It is clear that the testbeds need to define the value of the testbeds from a user perspective. Many testbeds experience challenges attracting SMEs irrespective of whether they focus on AM.Based on the investigation, this report formulates one key recommendation: Create a joint testbed building on the existing AM competences and facilities in Uppsala by combining existing testbeds (AM@Ångström and U-PRINT) into one testbed.That is, it is not viable to establish a totally new physical testbed as this would require several years of development and high investment costs. There are three main opportunities concerning this recommendation: 1) added value for Uppsala University and external users; 2) new user groups, and 3) specialization on life sciences.
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| 12. |
- Brantnell, Anders, 1983-, et al.
(author)
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The Roles and Involvement of Innovation Supporting Actors : Influence of IPR Ownership and IP Nature?
- 2020
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In: Academy of Management Annual Meeting Proceedings.
-
Conference paper (peer-reviewed)abstract
- Innovation supporting actors (ISAs), such as technology transfer offices (TTOs) and incubators, can play important roles in university-based innovation processes, e.g., handling patenting issues and providing business advice. However, few studies have provided theoretical explanations to ISA roles and involvement. In this study, we focus on the roles and involvement of ISAs in the medical field and explore how the roles are connected to two theoretical aspects, intellectual property rights (IPR) ownership and intellectual property (IP) nature. We select four cases based on theoretical sampling in terms of IPR ownership and IP nature. We conduct a proposition generating multiple case-study and develop five propositions stating, among others, that the number of ISA roles is more connected to IP nature than to IPR ownership, the types of ISA roles are more connected to IPR ownership than to IP nature, and ISA involvement in an innovation process is more connected to IP nature than to IPR ownership. The findings contribute to the literature on commercialization of science, technology transfer and innovation by demonstrating the influence of IPR ownership and IP nature on ISA roles and involvement. We end with policy and managerial implications.
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| 13. |
- Brantnell, Anders, 1983-, et al.
(author)
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Understanding the roles and involvement of technology transfer offices in the commercialization of university research
- 2022
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In: Technovation. - : Elsevier. - 0166-4972 .- 1879-2383. ; 115
-
Journal article (peer-reviewed)abstract
- Technology Transfer Offices (TTOs) can play important roles in university-based innovation processes, for example, by handling patenting issues and providing advice about funding. This study explores how patentability and ownership of academic inventions are connected to the roles and involvement of TTOs in commercialization of medical inventions. This in-depth exploration of four invention cases from two universities found that the number of TTO roles is related to patentability (i.e., patentable inventions entail more TTO roles than nonpatentable inventions), that the types of TTO roles are related to ownership (i.e., university-owned inventions entail more common roles than inventor-owned inventions), and TTO involvement in an innovation process is more related to patentability than to ownership (i.e., non-patentable inventions entail higher involvement than patentable inventions). We map the roles and divide them into two categories: intellectual property (IP) sheltering and intellectual property (IP) pushing. These categories align with previous understandings concerning TTO roles and contribute to theoretical and conceptual clarity. IP pushing is related more to inventor ownership than IP sheltering and IP sheltering is related more to university ownership than IP pushing.
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| 14. |
- Brantnell, Anders, 1983-, et al.
(author)
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Views of Implementers and Nonimplementers of Internet-Administered Cognitive Behavioral Therapy for Depression and Anxiety : Survey of Primary Care Decision Makers in Sweden
- 2020
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In: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 22:8
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Internet-administered cognitive behavioral therapy (ICBT) has been demonstrated to be an effective intervention for adults with depression and/or anxiety and is recommended in national guidelines for provision within Swedish primary care. However, the number and type of organizations that have implemented ICBT within primary care in Sweden is currently unclear. Further, there is a lack of knowledge concerning barriers and facilitators to ICBT implementation.OBJECTIVE: The two primary objectives were to identify and describe primary care organizations providing ICBT in Sweden and compare decision makers' (ie, directors of primary care organizations) views on barriers and facilitators to implementation of ICBT among ICBT implementers (ie, organizations that offered ICBT) and nonimplementers (ie, organizations that did not offer ICBT).METHODS: An online survey based on a checklist for identifying barriers and facilitators to implementation was developed and made accessible to decision makers from all primary care organizations in Sweden. The survey consisted of background questions (eg, provision of ICBT and number of persons working with ICBT) and barriers and facilitators relating to the following categories: users, therapists, ICBT programs, organizations, and wider society.RESULTS: The participation rate was 35.75% (404/1130). The majority (250/404, 61.8%) of participants were health care center directors and had backgrounds in nursing. Altogether, 89.8% (363/404) of the participating organizations provided CBT. A minority (83/404, 20.5%) of organizations offered ICBT. Most professionals delivering ICBT were psychologists (67/83, 80%) and social workers (31/83, 37%). The majority (61/83, 73%) of organizations had 1 to 2 persons delivering ICBT interventions. The number of patients treated with ICBT during the last 12 months was 1 to 10 in 65% (54/83) of the organizations, ranging between 1 and 400 treated patients across the whole sample. There were 9 significant (P<.05) differences out of 37 possible between implementers and nonimplementers. For example, more implementers (48/51, 94%) than nonimplementers (107/139, 76.9%) perceived few technical problems (P<.001), and more implementers (53/77, 68%) than nonimplementers (103/215, 47.9%) considered that their organization has resources to offer ICBT programs (P<.001).CONCLUSIONS: Despite research demonstrating the effectiveness of ICBT for depression and anxiety and national guidelines recommending its use, ICBT is implemented in few primary care organizations in Sweden. Several interesting differences between implementers and nonimplementers were identified, which may help inform interventions focusing on facilitating the implementation of ICBT.
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| 15. |
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| 16. |
- Palm, Klas, PhD, 1964-, et al.
(author)
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Identifying and Addressing Barriers and Facilitators for the Implementation of Internet of Things in Distributed Care : Protocol for a Case Study
- 2023
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In: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 12
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Journal article (peer-reviewed)abstract
- Background: The internet of things (IoT) is recognized as a valuable approach to supporting health care to achieve quality and person-centered care. This study aims to identify the facilitators and barriers associated with implementing IoT solutions in health care within a Scandinavian context. It addresses the pressing need to adapt health care systems to the demographic changes occurring in Scandinavia. The vision of "Vision eHealth 2025," a long-term strategic direction for digitalization in Sweden, serves as the background for this project. The implementation of IoT solutions is a crucial aspect of achieving the vision's goal of making Sweden a global leader in using digitalization and eHealth opportunities by 2025. IoT is recognized as a valuable approach to supporting health care to achieve quality and person-centered care. Previous research has shown that there is a gap in our understanding of social and organizational challenges related to IoT and that the implementation and introduction of new technology in health care is often problematic.Objective: In this study, we will identify facilitating and hindering factors for the implementation of IoT solutions in social and health care.Methods: We will use an explorative design with a case study approach. The data collection will comprise questionnaires and qualitative interviews. Also, a literature review will be conducted at the start of the project. Thus, quantitative and qualitative data will be collected concurrently and integrated into a convergent mixed methods approach.Results: As of June 2023, data for the review and 22 interviews with the stakeholders have been performed. The co-design with stakeholders will be performed in the fall of 2023.Conclusions: This study represents a unique and innovative opportunity to gain new knowledge relevant and useful for future implementation of new technology at health care organizations so they can continue to offer high-quality, person-centered care. The outcomes of this research will contribute to a better understanding of the conditions necessary to implement and fully use the potential of IoT solutions. By developing cocreated implementation strategies, the study seeks to bridge the gap between theory and practice. Ultimately, this project aims to facilitate the adoption of IoT solutions in health care for promoting improved patient care and using technology to meet the evolving needs of health care.
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| 17. |
- Schliemann, Marvin, 1995-, et al.
(author)
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Joining Forces for Better Care: The Implications of Logic Multiplicity in Multisectoral Partnerships
- 2023
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In: Academy of Management Proceedings. - United States of America.
-
Conference paper (peer-reviewed)abstract
- Confronted with grand challenges, multisectoral partnerships (MSPs) are an increasingly employed organizational approach to gather actors from various societal sectors. While the hope is that joining forces will allow us to address these challenges, MSPs are established in institutionally complex environments, which institutional theory has identified as a driver for conflicts within organizations. However, few studies have investigated the implications of logic multiplicity in MSPs. Drawing on an in-depth revelatory case study of an MSP for the development of 3D printing in healthcare, we provide rich data from the early years of development and compare qualitative and quantitative approaches to capture institutional logics. We build on logic compatibility and logic centrality to capture the implications of logic multiplicity for conflicts in an MSP. We find that both qualitative and quantitative approaches can capture institutional logics in MSPs and that a quantitative approach can be used to explore degrees of conflict in MSPs. These findings contribute to the institutional logics literature by illustrating how institutional logics can be used to study MSPs and how researchers can study logics through quantitative surveys. The findings contribute to management practice by exemplifying how managers could scan their MSPs for logics and level of conflict.
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| 18. |
- Svedin, Frida, Doktorand, et al.
(author)
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Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA) : a study protocol using codesign and participatory action research.
- 2021
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In: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Dementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context.METHODS AND ANALYSIS: A mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings.ETHICS AND DISSEMINATION: The study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.
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| 19. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Development and co-design of a behavioral activation intervention targeting depression among people with dementia for the Swedish context
- 2023
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Conference paper (peer-reviewed)abstract
- Background: Approximately 40% of people with dementia experience depression. Whilst psychological interventions are effective for the treatment of depression in dementia, access remains low. A behavioural activation self-help intervention, with support to the person with dementia to use the intervention provided by an informal caregiver, who themselves receives guidance from an occupational therapist (or other trained healthcare professional), may represent a solution.Objective: To develop a behavioral activation intervention targeting depression among people with dementia for the Swedish context together with key stakeholders.Methods: Semi-structured interviews and focus groups were held with people with dementia (n=8), informal caregivers (n=19), healthcare professionals (n=18), and non-governmental organisations (n=7) and analysed using manifest content analysis. A Public Advisory Group, consisting of informal caregivers of people with dementia (n=4), worked alongside the research team to support the interpretation and sense-making of research findings and co-design of the intervention.Results: An overarching theme ‘Tailoring and flexibility’ resulted from interviews and focus groups. Stakeholders expressed a need to adapt intervention material to increase relevancy and representativeness by: (1) adding multiple case stories to illustrate different life situations, age groups, ethnic backgrounds, and to increase relevance to Swedish society and culture; (2) designing new illustrations, as proposed illustrations were perceived old-fashioned and reinforced ageing and dementia stereotypes; and (3) reducing text to minimize treatment burden. Stakeholders also expressed a need for flexibility concerning intervention delivery and expressed a need for choice concerning: (1) location of guidance sessions to enable face-to-face sessions to be delivered in a familiar, safe, and convenient environment (e.g., home or familiar community setting); (2) mode of guidance (e.g., face-to-face, telephone, online); and (3) amount of guidance (e.g., frequency and number of guidance sessions).Conclusions: Results informed the development of a tailored intervention, optimised to improve acceptability, feasibility, and relevancy for people with dementia and depression. A planned feasibility study will further examine feasibility and acceptability of the intervention.Public involvement: Our Public Advisory Group has worked closely together with the research team to support the interpretation and sense-making of research findings and co-design the intervention to increase acceptability and relevancy of the intervention.
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| 20. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Effectiveness, acceptability, and completeness and quality of intervention reporting of psychological interventions for people with dementia or mild cognitive impairment : protocol for a mixed-methods systematic review
- 2023
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:12
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Journal article (peer-reviewed)abstract
- Introduction: Mental health difficulties such as anxiety and depression have negative impacts on psychological well-being and are common in people with dementia and mild cognitive impairment. However, access to psychological treatments is limited. This mixed-method systematic review will: (1) examine the effectiveness of psychological interventions to improve mental health and psychological well-being in people with dementia or mild cognitive impairment; (2) examine the effectiveness of these psychological interventions to improve mental health and psychological well-being in informal caregivers; (3) examine potential clinical and methodological moderators associated with effectiveness; (4) explore factors associated with the acceptability of psychological interventions from the perspective of key stakeholders; and (5) examine the completeness and quality of intervention reporting.Methods and analysis: Electronic databases (ASSIA, CENTRAL, CINAHL, EMBASE, PsycINFO and MEDLINE) will be systematically searched and supplemented with expert contact, reference and citation checking, and grey literature searches. If possible, we will conduct a meta-analysis to examine the overall effectiveness of psychological interventions to improve mental health and psychological well-being in people with dementia or mild cognitive impairment and their informal caregivers; and examine potential clinical and methodological moderators associated with effectiveness. We will conduct a deductive framework synthesis, informed by the theoretical framework of acceptability, to explore factors associated with the acceptability of psychological interventions from the perspective of key stakeholders. In accordance with Joanna Briggs Institute guidance, we will adopt a convergent segregated approach to data synthesis and integration of quantitative and qualitative findings. We will examine the completeness and quality of intervention reporting according to the Template for Intervention Description and Replication checklist and guide.Ethics and dissemination: No primary data will be collected, and therefore, ethical approval is not required. Results will be disseminated through a peer-reviewed publication, academic conferences, and plain language summaries.PROSPERO registration number: CRD42023400514.
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| 21. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Healthcare and community stakeholders' perceptions of barriers and facilitators to implementing a behavioral activation intervention for people with dementia and depression : a qualitative study using Normalization Process Theory
- 2023
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Journal article (peer-reviewed)abstract
- BackgroundDepression is commonly experienced by people with dementia, and associated with lower quality of life and functional decline. However, access to evidence-based psychological interventions for people with dementia and depression is limited. One potential solution is guided low-intensity behavioral activation. Following the new Medical Research Council Framework, considering factors such as potential barriers and facilitators to implementation is recommended during the development of new interventions. Aims of this study were to: (1) develop an understanding of existing healthcare and community support in the Swedish context for people with dementia and their informal caregivers; and (2) identify barriers and facilitators to intervention uptake informed by Normalization Process Theory.MethodsSemi-structured interviews and focus groups were held with healthcare (n = 18) and community (n = 7) stakeholders working with people with dementia and/or informal caregivers. Interview questions were informed by Normalization Process Theory. Data was analysed utilizing a two-step deductive analysis approach using the Normalization Process Theory coding manual, with inductive categories applied to data related to the main mechanisms of the theory, but not captured by its sub-constructs.ResultsTwelve deductive and three inductive categories related to three Normalization Process Theory primary mechanisms (Coherence, Cognitive Participation, and Collective Action) were identified. Identified barriers to intervention uptake included: (1) additional burden for informal caregivers; (2) lack of appropriate workforce to provide guidance; (3) lack of time and financial resources; (4) people with dementia not recognising their diagnosis of dementia and/or a need for support; and (5) stigma. Identified facilitators to intervention uptake included: (1) intervention has potential to fill a large psychological treatment gap in Sweden; (2) objectives and potential benefits understood and agreed by most stakeholders; and (3) some healthcare professionals recognized their potential role in providing intervention guidance.ConclusionsSeveral barriers and facilitators for future implementation, specific to the intervention, individuals and families, as well as professionals, were identified during intervention development. Barriers were mapped into evidence-based implementation strategies, which will be adopted to overcome identified barriers. A feasibility study further examining implementation potential, acceptability and feasibility, alongside clinical, methodological, and procedural uncertainties associated with the intervention will be conducted.
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| 22. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Professional stakeholders’ perceptions of barriers and facilitators to implementing a behavioural activation intervention for people with dementia
- 2024
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Conference paper (peer-reviewed)abstract
- Introduction: Depression is commonly experienced by people with dementia. Whilst evidence-based psychologicalinterventions are effective, a large psychological care gap remains. Behavioral activation may representa potential solution to close this gap. Following the MRC Framework for developing complexinterventions, considering potential barriers and facilitators to implementation is recommended duringintervention development. This study aimed to identify professional stakeholders’ perceptions of barriersand facilitators to future implementation.Methods: Following a topic guide informed by Normalization Process Theory (NPT), focus groups and semistructuredinterviews were held with healthcare professionals (n=18) and community stakeholders (n=7).Data was analyzed using the NPT coding manual, with inductive categories generated for data related tomain NPT mechanisms, but not captured by its sub-constructs.Results: A number of barriers and facilitators were identified. Facilitators include the proposed intervention: (1)has potential to fill a large psychological care gap; (2) has understandable and agreed upon objectivesand potential benefits; and (3) could easily be integrated into the lives of people with dementia and theirinformal caregivers. Barriers include lack of: (1) engagement from politicians and decision-makers; (2)appropriate workforce to provide intervention guidance; (3) time and financial resources.Conclusions: Results have informed the adaptation of a tailored intervention, optimized to improve futureimplementation potential. A subsequent feasibility study will further examine intervention feasibility andacceptability.
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| 23. |
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| 24. |
- Zheng, Xuewei, et al.
(author)
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Adoption of additive manufacturing in oral and maxillofacial surgery among university and non-university hospitals in Sweden : findings from a nationwide survey.
- 2023
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In: Oral and Maxillofacial Surgery. - : Springer Science and Business Media LLC. - 1865-1550 .- 1865-1569.
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Journal article (peer-reviewed)abstract
- PURPOSE: Additive manufacturing (AM) is an innovative printing technology that can manufacture 3-dimensional solid objects by adding layers of material from model data. AM in oral and maxillofacial surgery (OMFS) provides several clinical applications such as surgical guides and implants. However, the adoption of AM in OMFS is not well covered. The purpose was to study the adoption of AM in OMFS in university and non-university hospitals in Sweden. Three research questions were addressed: What is the degree of using AM solutions in university and non-university hospitals?; What are AM solutions used?; How are the AM solutions accessed (production mode) in university hospitals and non-university hospitals?METHODS: A survey was distributed to OMF surgeons in Sweden. The questionnaire consisted of 16 questions. Data were analyzed through descriptive and content analysis.RESULTS: A total of 14 university and non-university hospitals were captured. All 14 hospitals have adopted AM technology and 11 of the hospitals adopted AM in OMFS. Orthognathic and trauma surgery are two major types of surgery that involve AM technology where material extrusion and vat polymerization are the two most used AM technologies in OMFS. The primary application of AM was in medical models and guides.CONCLUSION: Majority of Swedish university hospitals and non-university hospitals have adopted AM in OMFS. The type of hospital (university or non-university hospital) has no impact on AM adoption. AM in OMFS in Sweden can be perceived to be a mature clinical application.
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