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To follow Phase I
(development) and II (feasibility) of the Medical Research Council (MRC)
Complex Interventions Framework, utilising a pragmatic realist approach. The
ESR project aims to further adapt and examine the feasibility and acceptability
of an eHealth solution within varying real-world practice contexts.

Whilst a plethora of evidence based
psychological interventions for informal carers exist, access to psychological
support across Europe remains limited. Potential explanations for poor access
include carer level barriers (e.g., lack of time, competing demands) and a lack
of appropriately trained professionals to deliver traditional psychological
support. A potential solution resides in eHealth solutions, providing not only
psychological support, but facilitating communication between all professionals
involved in care and assisting complex health and social care navigation.
However, much of the existing evidence base for eHealth solutions has been
generated in artificial research settings. As such, there is a lack of
knowledge concerning real-world delivery e.g., needs for adaptation across
varying healthcare settings/professionals/carer subgroups/cultures, barriers
and facilitators to implementation, and factors associated with long-term
sustainability across diverse contexts. The eHealth solution itself represents
an integration of a psychological treatment for carers developed in the UK
(CEDArS) with the U-CARE portal, which delivers eHealth interventions to
chronic health populations and family members. The ESR will utilise pragmatic
realist methods (formative case studies; pragmatic formative process
evaluation; realist feasibility study) to: (1) adapt the ehealth solution for
delivery within diverse real-world healthcare settings alongside key
stakeholders (carers, care recipients, healthcare professionals, industry); (2)
develop an understanding of barriers and facilities to implementation; (3)
appreciate variations in implementation across contexts, including factors that
may compromise intervention integrity; and (4) identify factors associated with
the long-term intervention sustainability.

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