O024 Factors influencing implementation of perinatal cognitive behavioural therapy for insomnia

Abstract Introduction Perinatal insomnia is a prevalent sleep concern which negatively impacts maternal and infant health. Although CBT-I is the recommended first-line treatment for insomnia, it is not routinely implemented in perinatal care in Australia. This study explored the factors (i.e., barriers and facilitators) influencing sustainable implementation and spread of CBT-I in perinatal care, as investigated in the SHINE (Sleep-Health-in-Perinatal-Care) randomised controlled trial. Methods Utilising a hybrid effectiveness-implementation type 1 design, n = 507 pregnant females were randomised to either CBT-I or active control. Of those randomised to CBT-I, 26 completed a qualitative semi-structured interview at six months postpartum. To date, eight key stakeholders (i.e., obstetricians/gynaecologists, general practitioners, psychologists), and four clinicians who delivered the program also completed interviews. Interview guides were informed by implementation science theory. Interviews were analysed thematically to identify and understand implementation barriers and facilitators. Results Preliminary results show that most participants (81%) found CBT-I beneficial, reporting improved sleep, wellbeing and understanding the CBT-I strategies. This was supported by clinicians, with 75% observing sleep improvement during delivery. Some intervention participants expressed a lack of support during the postpartum period (31%), a concern echoed by 50% of clinicians who noted the need for additional structured follow-up/check-ins to enhance participant support. Social support was identified as a facilitator in CBT-I adherence by participants and clinicians. Discussion Participants and clinicians found CBT-I useful. Key barriers and facilitators, such as maintenance treatment postpartum, perinatal stage and social support, should inform a tailored implementation strategy to accelerate sustainable uptake of CBT-I into routine care.