For a study, researchers sought to enhance the usage of e-health in lower social-economic status (SES) groups by implementing e-health therapies in the primary care setting with SES-sensitive coaching from General Practice nurses (GP nurses). They put into practice a web-based intervention that prioritizes primary care depressive concerns. An SES-sensitive (SES-sens) implementation strategy with additional face-to-face coaching from GP nurses was contrasted with an all-SES implementation strategy in a pragmatic cluster-randomized trial with 2 parallel groups. The major finding was the percentage of individuals in either condition who had a lower SES. A minimum of 1 in-person session and 2 online exercises must be finished to be registered as a participant. The examination of participation rates was done using mixed logistic modeling. Despite lower SES participants engaging at exceptionally high rates in all situations, the SES-sens implementation condition had a substantially lower engagement rate (44%) than the all-SES implementation condition (58%). Even after accounting for condition-by-condition interactions, this unexpected result was statistically significant (Odds Ratio 0.43, 95%-CI 0.22 to 0.81). GP nurses gave less instruction in the SES-sens group than was advised by the implementation recommendations. From the standpoint of public health, it was promising that many primary care patients with lower SES levels adopted the deployed e-health intervention. It was also encouraging that an SES-sensitive strategy underperformed an all-SES implementation strategy in terms of performance. However, this was a surprising finding, and it calls for more investigation into how to adapt e-health intervention implementation tactics for certain target populations in the context of primary care.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01793-w
