Healthcare providers’ experience of delivering a heart rate variability feedback intervention to individuals living with spinal cord injury to inform implementation into usual care

This study aimed to explore healthcare providers’ experiences of delivering heart rate variability feedback (HRV-F) therapy to individuals living with spinal cord injury (SCI) and identify potential facilitators and barriers to implementing HRV-F into usual rehabilitation care. Six healthcare providers involved in delivering HRV-F therapy participated in an interview. The interviews were dual coded to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) version 2.0 to identify potential barriers and facilitators for implementation. From the interviews, 166 facilitators and 187 barriers were identified and mapped into 29 interview statements for facilitators and 30 interview statements for barriers under CFIR domains, constructs and sub-constructs. The key facilitators included: (i) evidence-based implementation of HRV-F therapy, (ii) availability of champions and mentors among healthcare providers to promote delivery of HRV-F, and (iii) adaptability of HRV-F therapy to implement in different contexts and for different needs. Common barriers included: (i) workplace culture (ii) negative attitudes of healthcare providers towards HRV-F therapy, (iii) inadequate funding, (iv) information technology issues with HRV-F equipment, and (v) effectiveness of HRV-F for a wide range of individuals living with SCI. The findings highlight potential facilitators and implementation strategies to overcome identified barriers to ensure effective adoption of HRV-F therapy into usual rehabilitation practices for individuals living with SCI.