ADAPTING INTERVENTIONS FOR SUSTAINABLE IMPLEMENTATION IN NEW CONTEXTS: CONSIDERATIONS FROM A STUDY ON ENHANCING COLLABORATION BETWEEN PSYCHIATRIC CARE AND OCCUPATIONAL HEALTH SPECIALISTS

Background: The Coordinated Return to Work model, originally developed for an orthopaedic context, has been adapted for use in mental health settings. The model aims to enhance the collaboration between specialized psychiatric care and occupational health services. Its objective is to facilitate the return to work of employees with mental disorders by adopting a systemic approach that strengthens collaboration between public and private social and healthcare actors. Objectives: A previous implementation study investigated the facilitators and barriers to implementing the model. In this discussion paper, we contextualize the findings of that study within the latest literature on evaluating and adapting complex interventions. Materials and Methods: The implementation study findings serve as our primary data. We address the questions posed by Skivington et al. in their latest iteration of the framework for evaluating complex health interventions. These responses are intended to guide future research by determining whether further development, feasibility or evaluation studies are required. Results: Several challenges hindered the model’s implementation, including timing issues related to the new context and the qualitative differences between the original and adapted settings. Further feasibility analysis is recommended to address the practical, socio-cultural, and organizational challenges encountered during the implementation process. Conclusions: When considering the implementation of a model in a new context, knowledge about its effectiveness should not overshadow other vital factors. Decision makers must understand the key context-specific mechanisms and mediators that influence outcomes, from adaptation to impact. Sustainable adaptation demands thorough planning and adequate resources to ensure effective implementation.