Barriers and facilitators to implementing peer mentorship programs for individuals with spinal cord injury into rehabilitation hospitals: a multiple case study.

Abstract

To identify and compare barriers and facilitators to implementing a spinal cord injury (SCI) peer mentorship program at two rehabilitation hospitals. 24 participants from the two rehabilitation hospitals participated - 10 were from China and 14 were from Canada. Semi-structured interviews and focus groups were used to collect data. A cross-case analysis based on the Consolidated Framework for Implementation Research was conducted. At an individual level, four common facilitators for both hospitals were: <i>engaging patients with SCI</i>, <i>engaging health professionals</i>, <i>high-level leaders</i> providing financial and instrumental support, and increasing health professionals' <i>motivation</i> to implement the program. Two common barriers were health professionals' <i>low capability</i> and <i>opportunity</i> to implement the program. At an organizational level, one common facilitator was a <i>team culture</i> characterized by openness to innovation and a strong commitment to prioritizing patients' needs. For the Canadian hospital, their <i>partnership and connections</i> with a community-based SCI organization and collaborative <i>work infrastructure</i> were facilitators. For the Chinese hospital, team separation within the local <i>work infrastructure</i> was a barrier. Multiple barriers and facilitators to implementing SCI peer mentorship programs were identified in two culturally distinct contexts. Assessing organizational needs and identifying available resources are key pre-implementation processes for rehabilitation hospitals to implement SCI peer mentorship programs.