Despite the potential of digital health interventions to improve the delivery of psychoeducation to people with mental health problems and their relatives, and substantial investment in their development, there is little evidence of successful implementation into clinical practice. We report the first implementation study of a digital health intervention: Relatives Education And Coping Toolkit (REACT), into routine mental healthcare. Our main aim was to identify critical factors affecting staff uptake and use of this online self-management tool for relatives of people with psychosis or bipolar. A mixed-methods, theory-driven (Normalisation Process Theory), iterative multiple case study approach using qualitative analysis of interviews with staff and quantitative reporting of uptake. Carer researchers were part of the research team. In all, 281 staff and 159 relatives from Early Intervention teams across six catchment areas (cases) in England registered on REACT; 129 staff took part in qualitative interviews. Staff were positive about REACT helping services improve support and meet clinical targets. Implementation was hindered by: high staff caseloads and difficulties prioritising carers; perception of REACT implementation as research; technical difficulties using REACT; poor interoperability with trust computer systems and care pathways; lack of access to mobile technology and training; restricted forum populations; staff fears of risk, online trolling, and replacement by technology; and uncertainty around REACT’s long-term availability. Digital health interventions, such as REACT, should be iteratively developed, evaluated, adapted and implemented, in partnership with the services they aim to support, and as part of a long term national strategy to co-develop integrated technology-enabled mental healthcare. Implementation strategies must instil a sense of ownership for staff and ensure they have adequate IT training, appropriate governance protocols for online working, and adequate mobile technologies. Wider contextual factors including adequate funding for mental health services and prioritisation of carer support, also need to be addressed for successful implementation of carer focussed digital interventions. Study registration: ISCTRN 16267685.

中文翻译：

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实施针对精神病或双相情感障碍的在线亲戚工具包（IMPART研究）：反复进行的多案例研究，以确定影响员工使用和使用的关键因素。

尽管数字健康干预措施有可能改善对有精神健康问题的人及其亲属的心理教育，并为他们的发展投入大量资金，但几乎没有证据表明成功地将其实施到临床实践中。我们报告了数字健康干预的首次实施研究：亲戚教育和应对工具包（REACT），用于常规精神保健。我们的主要目的是确定影响员工吸收和使用此在线自我管理工具的重要因素，以帮助患有精神病或双相情感障碍的亲戚。一种混合方法，理论驱动（归一化过程理论），迭代多案例研究方法，使用对工作人员访谈的定性分析和摄取的定量报告。护理人员研究人员是研究团队的一部分。在所有，来自英格兰六个集水区（案）的早期干预团队的281名员工和159名亲属在REACT上注册；129名员工参加了定性访谈。工作人员对REACT帮助服务改善支持并达到临床目标持积极态度。实施工作受到以下因素的阻碍：工作人员的工作量大和照顾者优先考虑的困难；将REACT实施视为研究；使用REACT的技术困难；与信任计算机系统和护理途径的互操作性差；缺乏获得移动技术和培训的机会；论坛人口有限；员工担心风险，在线拖钓和被技术替代；以及REACT长期可用性的不确定性。数字医疗干预措施（例如REACT）应迭代开发，评估，改编和实施，与他们旨在支持的服务合作，并作为共同开发以技术为基础的综合心理保健的长期国家战略的一部分。实施策略必须灌输员工的主人翁意识，并确保他们具有适当的IT培训，适当的在线工作管理协议以及适当的移动技术。为了成功实施以照顾者为重点的数字干预措施，还需要解决更广泛的背景因素，包括为精神卫生服务提供足够的资金以及优先考虑照顾者。研究注册：ISCTRN 16267685。适用于在线工作的治理协议，以及适当的移动技术。为了成功实施以照顾者为重点的数字干预措施，还需要解决更广泛的背景因素，包括为精神卫生服务提供足够的资金以及优先考虑照顾者。研究注册：ISCTRN 16267685。适用于在线工作的治理协议，以及适当的移动技术。为了成功实施以照顾者为重点的数字干预措施，还需要解决更广泛的背景因素，包括为精神卫生服务提供足够的资金以及优先考虑照顾者。研究注册：ISCTRN 16267685。