Implementation of a Face-To-Face Vs Virtual Peer-Integrated Collaborative Care Intervention for Mental Health Treatment of Physical Trauma Survivors: A Qualitative Study of Lessons from the COVID-19 Pandemic.
Lawrence A Palinkas, Allison Engstrom, Tanya Knutsen et al.
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In 30 seconds
This qualitative study examined how the COVID-19 pandemic affected implementation of a peer-integrated collaborative care intervention for mental health among 450 patients receiving treatment for physical injuries. Seven clinician investigators used participant observation in a trauma care setting at a major US metropolitan hospital, with analysis involving an external mixed-methods specialist. Pandemic-related pressures and service changes created or worsened implementation barriers, including a temporary reduction in intervention reach. Although peer specialists felt virtual contact reduced their effectiveness, patient satisfaction assessments did not reflect this concern, and virtual delivery may have improved some implementation outcomes.
Key findings
- Pandemic-related service pressures and safety measures created or worsened multiple barriers, including provider shortages, recruitment suspension, scheduling difficulties, and increased interventionist workload.
- The intervention’s reach to its target population declined temporarily.
- Peer specialists perceived virtual interactions as less effective, but this was not reflected in patient satisfaction assessments.
- Virtual delivery may have improved some implementation outcomes, including adoption by Trauma Center staff.
Why it matters
The findings illustrate how public health emergencies can disrupt delivery of evidence-based mental health care in trauma settings through both system pressures and changes in how patients are reached. They also suggest that perceived loss of effectiveness with virtual contact may not align with patient satisfaction or all implementation outcomes, underscoring the value of assessing multiple perspectives when services change.
What to keep in mind
The findings are qualitative and based on participant observation by clinician investigators at one major metropolitan hospital, limiting generalisability.