The evaluation used mixed-method (mainly qualitative) methodology, structured and guided by a multi-level theoretical model (NASSS: non-adoption, abandonment and challenges to spread, scale-up and sustainability ), developed to explain individual and organisational challenges to adoption and sustained use of technology-supported programmes in health and care.
Between August 2019 and early March 2020, we undertook research with seven of the 14 local territorial Health Boards in Scotland, six of which we visited in person. These boards were selected to explore variation of experience in different geographical areas (urban, rural, islands) and in boards with higher and lower use of Attend Anywhere. We visited 11 sites across Scotland (10 hospitals, one GP surgery), conducted remote interviews with staff from a further 17 sites (7 hospitals, 7 GP practices, 2 community settings and one third-sector organisation), and observed some video consultations. We also met and interviewed senior-level stakeholders. In total, we conducted 140 interviews with doctors, nurses, allied health professionals, healthcare and third sector support workers, clinician and non-clinical managers, administrators, IT support staff, patients and their relatives, and national-level stakeholders (government, policy implementation, professional leaders, industry). The report also incorporates routinely-collected data on uptake of the service in different localities, extracted from the Attend Anywhere system.
We analysed data thematically, combining descriptive quantitative data with synthesized qualitative themes. Draft findings were presented to study participants in face-to-face and virtual meetings in February 2020 and a draft report was shared with the Scottish Government in March 2020. This report incorporates feedback from those consultations.
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