How patients contribute to an online psychoeducation forum for bipolar disorder: a virtual participant observation study

Background: In a recent exploratory randomized controlled trial, an online psychoeducation intervention for bipolar disorder has been found to be feasible and acceptable to patients and may positively impact on their self-management behaviors and quality of life. Objective: The objective of the study was to investigate how these patients contribute to an online forum for bipolar disorder and the issues relevant for them. Methods: Participants in the intervention arm of the Bipolar Interactive PsychoEDucation (“BIPED”) trial were invited to contribute to the Beating Bipolar forum alongside receiving interactive online psychoeducation modules. Within this virtual participant observation study, forum posts were analyzed using thematic analysis, incorporating aspects of discourse analysis. Results: The key themes which arose from the forum posts included: medication, employment, stigma, social support, coping strategies, insight and acceptance, the life chart, and negative experiences of health care. Participants frequently provided personal narratives relating to their history of bipolar disorder, life experiences, and backgrounds, which often contained emotive language and humor. They regularly sought and offered advice, and expressed encouragement and empathy. The forum would have benefitted from more users to offer a greater support network with more diverse views and experiences. Conclusions: Online forums are inexpensive to provide and may offer peer support and the opportunity for patients to share their experiences and explore issues related to their illness anonymously. Future research should focus on how to enhance patient engagement with online health care forums

Patients’ perspectives of the feasibility, acceptability and impact of a group-based psychoeducation programme for bipolar disorder: a qualitative analysis

Background: Although there is some quantitative evidence to suggest the benefits of group psychoeducation for people with bipolar disorder, patients’ perspectives and experiences of group psychoeducation require in-depth exploration to enable us to better understand the feasibility, acceptability and impact of these interventions, the potential facilitators and barriers to engagement, and how to improve these interventions in the future. Methods: In-depth, semi-structured interviews were conducted with 13 participants of a psychoeducation programme for bipolar disorder in Wales, following their involvement in the programme. The data were recorded and transcribed verbatim and analysed using thematic analysis. Results: Findings demonstrate that group psychoeducation may impact on participants’ perceived social support, knowledge and acceptance of bipolar disorder, personal insights, attitude towards medication and access to services. Key recommendations for improvement included: allowing more time for group discussions, offering group sessions to family members and avoiding use of hospital or university venues for the groups. Conclusions: This is the first qualitative study of patients’ perspectives of a UK-based group psychoeducation programme for people with bipolar disorder, and findings present an in-depth account of how group psychoeducation may be experienced by patients. The recommendations for improving the content and delivery of group psychoeducation for bipolar disorder may enhance engagement and widen access to such programmes. Future research into psychoeducation for bipolar disorder should explore how to target and engage people of diverse ethnic backgrounds and those in lower socioeconomic groups who are less likely to access healthcare services

A network approach to overcoming barriers to market engagement for SMEs in energy efficiency initiatives such as the Green Deal

The Green Deal (GD) was launched in 2013 by the UK Government as a market-led scheme to encourage uptake of energy efficiency measures in the UK and create green sector jobs. The scheme closed in July 2015 after 30 months due to government concerns over low uptake and industry standards but additional factors potentially contributed to its failure such as poor scheme design and lack of understanding of the customer and supply chain journey. We explore the role of key delivery agents of GD services, specifically SMEs, and we use the LoCal-Net project as a case study to examine the use of networks to identify and reduce barriers to SME market engagement. We find that SMEs experienced multiple barriers to interaction with the GD such as lack of access to information, training, and confusion over delivery of the scheme but benefited from interaction with the network to access information, improve understanding of the scheme, increasing networking opportunities and forming new business models and partnerships to reduce risk. The importance of SMEs as delivery agents and their role in the design of market-led schemes such as the GD are discussed with recommendations for improving SME engagement in green sector initiatives