Barriers and Facilitators to Implementing Web-Based Dementia Caregiver Education from the Clinician's Perspective: A Qualitative Study
Authors: Levinson Anthony J , Ayers Stephanie , Butler Lianna , Papaioannou Alexandra , Marr Sharon , Sztramko Richard 
Published: May 2020

Abstract
Background Internet-based dementia caregiver interventions have been shown to be effective for a range of caregiver outcomes, yet little is known about how best to implement them. We developed iGeriCare, an evidence-based, multimedia, online educational resource for family caregivers of people living with dementia. The objectives of this study were to get feedback and opinions from experts and clinicians involved in dementia care and caregiver education about 1) iGeriCare, and 2) barriers and facilitators to implementing an online caregiver program.Methods We performed semi-structured interviews with individuals who had a role in dementia care/caregiver education in several key stakeholder settings in Southern Ontario, Canada. We queried participants’ perceptions of iGeriCare, caregiver education, the implementation process and their experience with facilitators and barriers. Transcripts were coded and analyzed using a grounded theory approach. The themes that emerged were organized using the Consolidated Framework for Implementation Research (CFIR).Results Twelve participants from a range of disciplines described their perceptions of iGeriCare, and identified barriers and facilitators to implementation of the intervention. The intervention was generally perceived as a high-quality resource for caregiver education and support, with many stakeholders highlighting the relative advantage of a web-based format. The intervention was seen to meet dementia caregiver needs, partially due to its flexibility, accessibility and compatibility within existing clinical workflows. Additionally, the intervention helps to overcome time constraints for both caregivers and clinicians.Conclusions Study findings indicate a generally positive response for the use of internet-based interventions for dementia caregiver education. Results suggest that iGeriCare may be a useful clinical resource to complement traditional face-to-face and print material caregiver education. More comprehensive studies are required to identify the effectiveness and longevity of online caregiver education interventions, and continue to better understand barriers and facilitators with respect to the implementation of technology-enhanced caregiver educational interventions in various healthcare settings.Contributions to the literature· The need for dementia caregiver education has been identified as a priority in numerous provincial, national, and global Dementia Strategies. Research has shown that web-based caregiver education interventions may result in a range of improved health outcomes for caregivers, including reductions in depression, stress, distress and anxiety.· Opinion leaders in dementia care were generally enthusiastic about implementing high quality web-based dementia caregiver education. · Our findings contribute to the gaps in the literature, including barriers and facilitators into implementation of web-based caregiver educational resources in traditional clinical workflows.