Author:
Craven Kristelle,Holmes Jain,Powers Katie,Clarke Sara,Cripps Rachel L.,Lindley Rebecca,Phillips Julie,Tyerman Ruth,McKevitt Christopher,Clarke David,Radford Kathryn
Abstract
Abstract
Background
Little guidance exists regarding how best to upskill and support those delivering complex healthcare interventions to ensure robust trial outcomes and implementation fidelity. Mentoring was provided to occupational therapists (OTs) delivering a complex vocational rehabilitation (VR) intervention to stroke survivors. This study aimed to explore mentors’ roles in supporting OTs with intervention delivery and fidelity, and to describe factors affecting the mentoring process and intervention delivery.
Methods
Quantitative data (duration, mode and total time of mentoring support) was extracted from mentoring records and emails between mentors and OTs, alongside qualitative data on barriers and facilitators to intervention delivery. Semi-structured interviews with mentors (n = 6) and OTs (n = 19) explored experiences and perceptions of intervention training, delivery and the mentoring process. Mean total and monthly time spent mentoring were calculated per trial site. Qualitative data were analysed thematically.
Results
Forty-one OTs across 16 sites were mentored between March 2018 and April 2020. Most mentoring was provided by phone or Microsoft Teams (range: 88.6–100%), with the remainder via email and SMS (Short Message Service) text messages. Mentors suggested strategies to enhance trial recruitment, improved OTs’ understanding of- and adherence to trial processes, intervention delivery and fidelity, and facilitated independent problem-solving. Barriers to mentoring included OT non-attendance at mentoring sessions and mentors struggling to balance mentoring with clinical roles. Facilitators included support from the trial team and mentors having protected time for mentoring.
Conclusions
Mentoring supported mentee OTs in various ways, but it remains unclear to what extent the OTS would have been able to deliver the intervention without mentoring support, or how this might have impacted fidelity. Successful implementation of mentoring alongside new complex interventions may increase the likelihood of intervention effectiveness being observed and sustained in real-life contexts. Further research is needed to investigate how mentors could be selected, upskilled, funded and mentoring provided to maximise impact. The clinical- and cost-effectiveness of mentoring as an implementation strategy and its impact on fidelity also requires testing in a future trial.
Trial registration
ISRCTN, ISRCTN12464275. Registered on 13th March 2018.
Publisher
Springer Science and Business Media LLC
Subject
Health Informatics,Epidemiology
Reference47 articles.
1. Walker MF, Hoffmann TC, Brady MC, Dean CM, Eng JJ, Farrin AJ, et al. Improving the development, monitoring and reporting of stroke rehabilitation research: consensus-based core recommendations from the stroke recovery and rehabilitation roundtable. Int J Stroke. 2017;12(5):472–9. https://doi.org/10.1177/1747493017711815.
2. Dopp CME, Graff MJL, Teerenstra S, Adang EMM. Nijhuis-van der Sanden MWG, Olde Rikkert MGM, et al. a new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial. BMC Geriatr. 2011;11(1):13. https://doi.org/10.1186/1471-2318-11-13.
3. National Institute for Health Research (NIHR). Clinical trials guide for trainees: guidance to support NIHR trainees interested in getting involved in clinical trials. 2015. https://www.nihr.ac.uk/documents/clinical-trials-guide/20595. Accessed 15 March 2021.
4. Holmes JA, Logan P, Morris R, Radford K. Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review. Syst Rev. 2020;9(1):268. https://doi.org/10.1186/s13643-020-01508-1.
5. Radford KA, Sutton C, Sach T, Holmes J, Watkins CL, Forshaw D, et al. Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT. Health Technol Assess. 2018;22(33).
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献