Fill the implementation gap: a mixed methods study of theory-based adaptation and implementation approaches and processes of a low-dose psychosocial intervention for caregivers


"Fill the implementation gap: a mixed methods study of theory-based adaptation and implementation approaches and processes of a low-dose psychosocial intervention for caregivers" co-supervised by Professor Emiliano Albanese of Università della Svizzera italiana and Dr. Marianna Purgato of the University of Verona. The project is sponsored by the Swiss National Science Foundation (doc.CH grant).

Informal caregivers are unpaid individuals who provide pivotal care, assistance, and treatment to a relative, a friend, or an acquaintance facing illness, disability, or any condition requiring support. In Switzerland, nearly one in 20 people are family caregivers. Caregiving may be associated with psychological distress and frequently leads to negative impacts on both mental and physical health outcomes. Addressing psychological distress is important not only for caregivers, but also for care recipients, and society at large.

The project falls within the scope of mental health and implementation research. In particular, the project aims to adapt an intervention originally developed by the WHO for Ticino’s community of family caregivers (“Doing What Matters in Times of Stress” (DWM)). The intervention is psychosocial and digitally available. It aims to give family caregivers access to a tool that can reduce stress levels associated with care and treatment, without and independent of mediation by a healthcare professional.

After the linguistic, cultural, and contextual adaptation phase, we will test not only the effectiveness of the intervention, but, especially, potential barriers and facilitators to its use and implementation outcomes (e.g., acceptability, appropriateness, feasibility, fidelity…) will be considered, which are important aspects of understanding how to implement at scale and maintain the intervention over time in a sustainable manner.

The project is divided into three studies and will be developed over four years.

The first study aims to synthesize scientific evidence (through systematic literature reviews) on how the successful implementation of a mental health intervention is measured and its effectiveness. We will focus on identifying and measuring indicators.

The second study aims to adapt the intervention within Ticino, so that it is relevant, accessible and user-friendly for family caregivers, and sustainable over time. Barriers and facilitators to implementation will be identified.

The third study aims to test the effectiveness of the intervention in reducing stress levels and improving mental health and well-being of family caregivers. We will also study how and why the intervention works, focusing on the implementation process.

One of the practical implications of our project is to understand whether, how, and how much it is possible to reduce stress and improve the mental health of Ticino's family caregivers.

The project also has the ambition to help advance our knowledge of methods, and of conducting implementation studies of complex interventions. This is a very important area of research for public health, and still relatively unexplored.



Beatrice Bano (IPH)

Emiliano Albanese (IPH)


Marianna Purgato (Università di Verona, IT)




WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation and Cochrane Global Mental Health Centre, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy (Prof. Corrado Barbui; Dott.ssa Marianna Purgato)