Staff perspectives on the implementation of interventions for people with congenital disabilities: a mixed-methods systematic review.

backgroundThe implementation of interventions in clinical practices is a challenge in healthcare settings, particularly in the field of habilitation. Although research on interventions in this area has increased, research on the implementation of these interventions has been slow. Exploring staff experience of implementation is therefore crucial to optimize the likelihood that interventions will be adopted and sustained in habilitation settings. The purpose of this systematic review is to synthesize the experiences of staff in implementing interventions for adults with congenital disabilities into a comprehensive overview.

methodsStudies were included if they provided empirical data on staff experiences of implementing interventions for adults with congenital disabilities in health and social care settings, regardless of study design. Non-empirical studies and grey literature were excluded. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, we conducted a search using the Medline, CINAHL, PsycInfo, Sociological Abstract, Applied Social Sciences Index and Abstracts (ASSIA), and Web of Science databases. The last search update was conducted in February 2024. The Critical Appraisal Skills Program (CASP) tool was used for qualitative studies, and the Mixed-Method Assessment Tool (MMAT) for the quantitative and mixed-method studies. The Convergent Integrated Approach (CIA) was employed to synthesize the data.

resultsOf the 5855 studies initially retrieved, eight met the inclusion criteria. The analysis and integration of all included studies were categorized into three themes: (1) conditions for implementation, (2) acceptability of the intervention, and (3) approaches for change. The results underscore the importance of organizational resources, vision, and collaboration in successful implementation.

conclusionsActive participation of professionals and alignment of interventions with existing practices were identified as key factors for success. The consideration of external factors that can influence the implementation of interventions is also important. In general, these findings provide information to guide future planning and implementation of interventions within habilitation settings. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/SBV9E.