Background: We conducted a trial to test the electronic Illness Management and Recovery (e-IMR) intervention to provide conclusions on the potential efficacy of eHealth for people with severe mental illness (SMI). In the e-IMR intervention, we used the standard IMR program content and methodology and combined face-to-face sessions with internet-based strategies on the constructed e-IMR internet platform. During the trial, the e-IMR platform was sparsely used. Objective: This study aimed to evaluate the added value of the e-IMR intervention and the barriers and facilitators that can explain the low use of the e-IMR platform. Methods: This process evaluation was designed alongside a multicenter, cluster randomized controlled trial. In this study, we included all available participants and trainers from the intervention arm of the trial. Baseline characteristics were used to compare users with nonusers. Qualitative data were gathered at the end of the semistructured interviews. Using theoretical thematic analyses, the data were analyzed deductively using a pre-existing coding frame. Results: Out of 41 eligible participants and 14 trainers, 27 participants and 11 trainers were interviewed. Of the 27 participants, 10 were identified as users. eHealth components that had added value were the persuasive nature of the goal-tracking sheets, monitoring, and the peer testimonials, which had the potential to enhance group discussions and disclosure by participants. The low use of the e-IMR platform was influenced by the inflexibility of the platform, the lack of information technology (IT) resources, the group context, participants’ low computer skills and disabilities, and the hesitant eHealth attitude of the trainers. Conclusions: The extent of eHealth readiness and correlations with vulnerabilities in persons with SMI need further investigation. This study shows that flexible options were needed for the use of e-IMR components and that options should be provided only in response to a participant’s need. Use of the e-IMR intervention in the future is preconditioned by checking the available IT resources (such as tablets for participants) providing computer or internet guidance to participants outside the group sessions, evaluating the eHealth attitude and skills of trainers, and tailoring eHealth training to increase the skills of future e-IMR trainers. Trial Registration: Netherlands Trial Register NTR4772; https://www.trialregister.nl/trial/4621

中文翻译：

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针对重度精神疾病患者的混合式电子疾病管理和恢复计划：定性过程评估以及随机对照试验

背景：我们进行了一项试验，以测试电子疾病管理和恢复（e-IMR）干预措施，以提供有关eHealth对重度精神疾病（SMI）的潜在疗效的结论。在e-IMR干预中，我们使用了标准的IMR计划内容和方法，并在构建的e-IMR互联网平台上将面对面的会议与基于互联网的策略相结合。在试用期间，很少使用e-IMR平台。目的：本研究旨在评估e-IMR干预的附加价值以及可以解释e-IMR平台使用率低的障碍和促进因素。方法：该过程评估是与多中心，集群随机对照试验一起设计的。在这项研究中，我们纳入了试验干预部门中所有可用的参与者和培训师。基线特征用于比较用户与非用户。在半结构化访谈结束时收集了定性数据。使用理论主题分析，使用预先存在的编码框架对数据进行演绎分析。结果：在41名合格参与者和14名培训师中，有27名参与者和11名培训师接受了采访。在27位参与者中，有10位被确定为用户。具有附加价值的eHealth组件是目标跟踪表，监控和同伴推荐的说服力，可以增强参与者的小组讨论和信息披露的潜力。e-IMR平台使用率低受到以下因素的影响：平台的灵活性，信息技术（IT）资源的缺乏，小组背景，参与者的计算机技能和残疾程度低以及培训师对eHealth态度犹豫不决。结论：SMI患者对eHealth的准备程度以及与脆弱性的关系需要进一步调查。这项研究表明，使用e-IMR组件需要灵活的选择，并且仅应根据参与者的需求提供选择。通过检查可用的IT资源（例如参加者的平板电脑）来为将来使用e-IMR干预做准备，该信息资源可为小组会议以外的参加者提供计算机或互联网指导，评估其eHealth态度和培训者的技能，并定制eHealth培训以增加未来的e-IMR培训师的技能。试用注册：荷兰试用注册NTR4772；https://www.trialregister.nl/trial/4621