Early development of a contextually appropriate psychological intervention for skilled nursing facilities: a...

This study describes the application of the Designing for Accelerated Translation (DART) and Intervention Mapping (IM) frameworks to the early development of a psychological intervention for depression in short-term subacute/post-acute skilled nursing facility (SNF) care.

We conducted five focus groups with 32 SNF staff and individual interviews with 28 residents and 18 care partners. Data were analyzed using a hybrid inductive-deductive coding structure to map themes onto the DART framework (i.e. eliciting demand, user-centered design, and context-sensitive approaches). Staff and dyad members' findings were triangulated. Then, IM was used to translate qualitative findings into intervention components.

Participants reported demand for psychological intervention with potential benefits for both residents and care partners during a SNF stay. Second, five themes were identified to guide intervention content: fear and worry; emotional reactions to changes in independence; motivation for rehabilitation; stress and conflict complicating discharge and long-term care; and healthy coping strategies. Third, participants noted context-sensitive approaches for implementation (e.g. session length of 20-30 min). Based on findings, we identified change objectives and methods for psychological intervention.

This study provides an overview of early intervention development processes that consider implementation and dissemination in real-world SNF settings.