Barriers and facilitators to implementing peer mentorship programs for individuals with spinal cord injury into rehabilitation hospitals: a multiple case study.

Abstract

Purpose: To identify and compare barriers and facilitators to implementing a spinal cord injury (SCI) peer mentorship program at two rehabilitation hospitals.

Materials and methods: 24 participants from the two rehabilitation hospitals participated - 10 were from China and 14 were from Canada. Semi-structured interviews and focus groups were used to collect data. A cross-case analysis based on the Consolidated Framework for Implementation Research was conducted.

Results: At an individual level, four common facilitators for both hospitals were: engaging patients with SCI, engaging health professionals, high-level leaders providing financial and instrumental support, and increasing health professionals' motivation to implement the program. Two common barriers were health professionals' low capability and opportunity to implement the program. At an organizational level, one common facilitator was a team culture characterized by openness to innovation and a strong commitment to prioritizing patients' needs. For the Canadian hospital, their partnership and connections with a community-based SCI organization and collaborative work infrastructure were facilitators. For the Chinese hospital, team separation within the local work infrastructure was a barrier.

Conclusions: Multiple barriers and facilitators to implementing SCI peer mentorship programs were identified in two culturally distinct contexts. Assessing organizational needs and identifying available resources are key pre-implementation processes for rehabilitation hospitals to implement SCI peer mentorship programs.