Evaluating the Redesigning Daily Occupations (ReDO-10®) programme for women with stress in Ireland: A feasibility study and process evaluation
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Date
2023-01-09Author
Fox, Jackie
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Abstract
Mental health interventions are in high demand in primary care in Ireland where
psychological distress is commonly seen as a reason for presenting to general practice.
Women present more frequently with stress and anxiety. Occupational therapists have the
potential to meet the needs of this population with programmes such as Redesigning Daily
Occupations (ReDO®-10). The objectives of this research were to (1) explore the feasibility,
acceptability and potential effectiveness of the ReDO®-10 programme as it was implemented
for the first time in an Irish primary care setting and (2) to analyse the mechanisms of action
of this programme to understand the process of change for participants. Women were
recruited from general practice sites and through self-referral over two phases in 2018 and
2019. In total, 31 women expressed interest and 15 were recruited. ReDO®-10 group
sessions were delivered by primary care occupational therapists who had received training
and certification. Outcomes measured at three time points included; functioning,
psychological distress, mastery, occupational value and perceived health. Qualitative
interviews with participants, general practitioners and occupational therapists were analysed
to understand the feasibility and acceptability of the intervention. A separate analysis of
participant narratives informed a directed content analysis based on the Behaviour Change
Wheel to understand mechanisms of action.
ReDO®-10 was found to be acceptable and feasible in this small study. However, it
required considerable resources of time from occupational therapists and general
practitioners. The group support was highly valued and women reported changes in their
patterns of occupations, choosing more occupations for health and restoration and finding
greater autonomy in home settings. The analysis informed by the Behaviour Change Wheel
showed that the practice of occupations between sessions and the occupational self-analysis
aspects of the programme were particularly influential in changes that occurred. This study
informs future research on the ReDO®-10 and other programmes by providing information
on aspects of feasibility, outcome measurement, recruitment challenges and data analysis. It
also provides important data to understand how occupation-focused interventions may work
to bring about changes for those who take part in them.