JMIR Publications

ABSTRACT

Background:

Implementing technology-based counselling as a complex intervention into dementia care poses challenges such as adaption to stakeholders’ needs and limited resources. Although studies have examined the effectiveness of technology-based counselling, its successful implementation remains largely unexplored.

Objective:

We aimed to review the knowledge about implementation success of technology-based counselling interventions for people with dementia and their informal carers.

Methods:

We conducted a scoping review and systematically searched CINAHL, Cochrane Library including Cochrane Central Register of Controlled Trials, MEDLINE, PsycInfo, and Web of Science Core Collection (April 2021) in combination with citation searching and web searching (November 2021). Studies reporting on technology-based counselling interventions for people with dementia and/or their informal carers were included irrespective of the design. We used the Conceptual Framework for Implementation Outcomes to operationalize ‘implementation success’ and applied the outcomes acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability as categories to inform data extraction. We identified dimensions within the categories and synthesized results narratively and graphically.

Results:

We included 52 publications reporting on 27 technology-based counselling interventions. Studies were conducted in nine countries and published between 1993 and 2021. As the design of the included studies varied, the number of participants and the type of data reported varied as well. The intervention programs were heterogeneous and ranged from single counselling interventions (such as helpline services) to counselling as part of a multi-component program. Telephone, email, videoconferencing, social media respectively chats, and web-based platforms were used for delivering counselling. We found data on appropriateness for all interventions and data on acceptability for most interventions, describing aspects such as consumer-perceived usefulness and helpfulness of services, as well as satisfaction. Information on the other categories adoption, feasibility, fidelity, implementation cost, penetration, and sustainability were fragmented.

Conclusions:

Scope and depth of information on conceptual categories of implementation success of technology-based counselling for people with dementia and informal carers varied. The data only partially covered the concept of ‘implementation success’, which highlights the need for a systematic evaluation accompanying the implementation. The application of theoretical approaches for implementation and adherence to the Framework for Developing and Evaluating Complex Interventions are required to promote implementation of complex interventions and to comprehensively assess implementation success. Clinical Trial: PROSPERO CRD42021245473