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dc.contributor.authorDarker, Catherine
dc.date.accessioned2024-03-19T10:26:53Z
dc.date.available2024-03-19T10:26:53Z
dc.date.issued2024
dc.date.submitted2024en
dc.identifier.citationDarker, C.D., Nicolson, G., Reddon, H., O'Connor, K., Jennings, R., & O'Connell, N., Monthly engagement with EIP keyworkers was associated with a five-fold increase in the odds of engagement with psychosocial interventions, BMC Psychiatry. 2024 Feb 5;24(1):96en
dc.identifier.otherY
dc.identifier.urihttp://hdl.handle.net/2262/107330
dc.descriptionPUBLISHEDen
dc.description.abstractBackground: Early intervention in psychosis (EIP) supports people who are experiencing their first episode of psychosis (FEP). A new Model of Care (MoC) for EIP services was launched in Ireland in 2019. Three EIP demonstration sites were chosen to test this MoC through a 'hub and spoke' approach. These services were a new way of organising care for people experiencing FEP, based upon a recovery model of care, and which sought to standardise care, improve access by clinically led multidisciplinary teams. This included newly created EIP keyworker roles whereby keyworkers assumed responsibilities regarding assessment, comprehensive individual care planning and coordination of care. Methods: A mixed methods design utilising the UK Medical Research Council's process evaluation framework. Purposive sampling techniques were utilised. Descriptive analyses and logistic regression were performed to examine how increased keyworker engagement influenced the use of other psychosocial interventions within the EIP demonstration sites. Thematic analyses was used for qualitative data. Results: There was a strong positive relationship between keyworker contacts and psychosocial interventions offered. Specifically, the odds of achieving at least monthly engagement with cognitive behavioural therapy for psychosis (CBTp; (5.76 (2.43-13.64), p < 0.001), and behavioural family therapy (BFT; (5.52(1.63-18.69, p < 0.006)) increased by fivefold with each additional monthly keyworker contact. For individual placement support (IPS) each additional monthly keyworker contact was associated with a three-fold increase in the odds of achieving monthly attendance with IPS (3.73 (1.64-8.48), p < 0.002). Qualitative results found that the EIP keyworker role as viewed by both service users and staff as a valuable nodal point, with a particular emphasis on care coordination and effective communication. Conclusions: This study advances the understanding of keyworker effects through qualitative evidence of keyworkers functioning as a "linchpin" to the service, while the positive response association between keyworker contacts and engagement with other services provides quantitative support for keyworkers reducing the organisational or structural barriers to service access. Given the importance of these positions, health systems should ensure that EIP programmes identify qualified and experienced staff to fill these roles, as well as allocate the appropriate funding and protected time to support keyworker engagement and impact.en
dc.language.isoenen
dc.relation.ispartofseriesBMC Psychiatry;
dc.relation.ispartofseries24;
dc.relation.ispartofseries96;
dc.rightsYen
dc.subjectCare coordinator; Demonstration sites; Early intervention in psychosis; Engagement; First episode psychosis; Keyworker; Model of care; Process evaluation; Qualitativeen
dc.titleMonthly engagement with EIP keyworkers was associated with a five-fold increase in the odds of engagement with psychosocial interventionsen
dc.typeJournal Articleen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/darkerc
dc.identifier.rssinternalid264114
dc.identifier.doidoi.org/10.1186/s12888-024-05577-7
dc.rights.ecaccessrightsopenAccess
dc.subject.TCDThemeInclusive Societyen
dc.subject.TCDTagCOMMUNITY MENTAL HEALTH SERVICESen
dc.subject.TCDTagHEALTH SERVICES RESEARCHen
dc.subject.TCDTagMedicineen
dc.identifier.rssurihttps://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05577-7#article-info
dc.identifier.orcid_id0000-0002-1561-7076
dc.status.accessibleNen


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