JMIR Publications

ABSTRACT

Despite numerous promises of digital mental health innovations to improve access to mental health services, the integration of technology into clinical care settings often faces multi-faceted challenges. In response, the importance of implementation science is gaining growing recognition. In this paper, we present our adaptation of an existing implementation toolkit, the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability - Complexity Assessment Toolkit (NASSS - CAT), to the Quebec and Canadian health care system. Within the initiative of the Douglas Data and Digital Science for Mental Health (D3SM), our goal was to create a digital implementation toolkit to support integration of digital mental health innovations into real-world settings. The adaptation process included: 1) Narrative review, 2) Selection of NASSS-CAT, 3) Review and selection of NASSS-CAT relevant questions, 4) Learning from an external digital mental health innovation project, 5) Piloting, 6) Quebec and Canadian contextualization, 7) Consideration for equity and accessibility, 8) Prototyping and refinement. To enhance user engagement, the D3SM implementation toolkit is available in an interactive online format in English and French. Users will be guided to access selected resources which are tailored to the location provided. Visualization is intended to help users identify specific domains that require more input and actions. The progress of efforts to address uncertainty and complexity can also be monitored over time through regular assessment. In addition, given the rapidly changing landscape of technology advancement and regulatory context, the webform allows us to easily provide the most updated resource information. Although it is still too early to report on the usefulness of the D3SM implementation toolkit, our experience demonstrates that adapting the NASSS-CAT Long version to the local health care system context provides valuable implementation insights for research teams. We highlight not only the value of applying this implementation science framework with a specific focus on technology, but also the importance of considering the multi-layered health system context which is uniquely shaped by numerous attributes and features.