@Article{info:doi/10.2196/mental.9600,
author="Hermes, Eric
and Burrone, Laura
and Perez, Elliottnell
and Martino, Steve
and Rowe, Michael",
title="Implementing Internet-Based Self-Care Programs in Primary Care: Qualitative Analysis of Determinants of Practice for Patients and Providers",
journal="JMIR Ment Health",
year="2018",
month="May",
day="18",
volume="5",
number="2",
pages="e42",
keywords="cognitive behavioral therapy; internet-based therapy; health information technology; behavioral intervention technology; internet; Veterans",
abstract="Background: Access to evidence-based interventions for common mental health conditions is limited due to geographic distance, scheduling, stigma, and provider availability. Internet-based self-care programs may mitigate these barriers. However, little is known about internet-based self-care program implementation in US health care systems. Objective: The objective of this study was to identify determinants of practice for internet-based self-care program use in primary care by eliciting provider and administrator perspectives on internet-based self-care program implementation. Methods: The objective was explored through qualitative analysis of semistructured interviews with primary care providers and administrators from the Veterans Health Administration. Participants were identified using a reputation-based snowball design. Interviews focused on identifying determinants of practice for the use of internet-based self-care programs at the point of care in Veterans Health Administration primary care. Qualitative analysis of transcripts was performed using thematic coding. Results: A total of 20 physicians, psychologists, social workers, and nurses participated in interviews. Among this group, internet-based self-care program use was relatively low, but support for the platform was assessed as relatively high. Themes were organized into determinants active at patient and provider levels. Perceived patient-level determinants included literacy, age, internet access, patient expectations, internet-based self-care program fit with patient experiences, interest and motivation, and face-to-face human contact. Perceived provider-level determinants included familiarity with internet-based self-care programs, changes to traditional care delivery, face-to-face human contact, competing demands, and age. Conclusions: This exploration of perspectives on internet-based self-care program implementation among Veterans Health Administration providers and administrators revealed key determinants of practice, which can be used to develop comprehensive strategies for the implementation of internet-based self-care programs in primary care settings. ",
issn="2368-7959",
doi="10.2196/mental.9600",
url="http://mental.jmir.org/2018/2/e42/",
url="https://doi.org/10.2196/mental.9600",
url="http://www.ncbi.nlm.nih.gov/pubmed/29776898"
}