Implementing work-related Mental health guidelines in general PRacticE (IMPRovE): A trial evaluating the impact of a complex intervention involving a digital Community of Practice and academic detailing on guideline adherence

The intervention will comprise academic detailing (AD) specifically for study, participation in a digital community of practice (CoP) specifically for study, and provision of resources which are readily available. The CoP is an online portal designed to benefit GPs’ delivery of treatment to patients who present with work-related mental health problems. As an online community equipped with learning resources and facilitated by Monash University personnel, the CoP will be created as a purpose-designed platform of information sharing, exchange, and practitioner engagement. Academic Detailing We will appoint GPs who currently provide independent advice to compensation scheme regulators as Academic Detailers and provide them with training on the Clinical Guideline for the Diagnosis and Management of Work-related Mental Health Conditions in General Practice (the Guideline). Each GP cluster (GP clinic) will be detailed on how to improve care for patients with work-related mental health conditions in accordance with the Guideline. This will include receiving a suite of resources such as the Guideline recommendations and resources supplied by the partners. Academic detailers will also invite GP participation in a digital CoP and enrol them as members to this community. Delivering the face-to-face AD session will be GPs who are also seen to be Clinical Opinion Leaders, highly respected amongst their peers and well-versed in the complexities around the workers’ compensation system. Each of the participation GP will attend one academic session in their GP practice (locations of rural, remote and urban clinics across both NSW and Victoria) before they are enrolled on the CoP. The Academic Detailing (AD) Session will follow a set structure but may be adjusted according to the needs of the GPs who attend a detailing session. Community of Practice Participation in a CoP provides support for practitioners who can feel isolated in dealing with clinical problems, helping them to create networks and implement new models of care. We will create a virtual CoP. The CoP will highlight the Guideline and its recommendations through the use of quizzes, case studies, questions and answers and by providing participants with education and resources, as well as those produced independently by our partners. This will enable participating GPs to develop a shared repertoire of resources and ways of addressing recurring problems. The CoP is intended as a platform and a forum for a broad dissemination of knowledge and a broad and growing level of demonstrable expertise in work-related mental health care. As in all areas of medicine, mental health practice and treatment evolves and improves with the active involvement of a wide range of practitioners with a wide range of experiences and expertise. To expand the competence among GPs in Australia when treating work-related mental health problems, it is expected that the GPs involved in the CoP will be able and prepared to contribute their insights, knowledge, and experience. It is the vision of the IMPRovE program that learners become teachers and the velocity of knowledge and understanding increases as members increase in number and as their exposure to the CoP grows over time. The CoP does provide digital resources and assets for members, which are as described below: • The discussion board/forum is a digital place where members can discuss ideas, ask and answer questions of each other, partake in debates around treatment protocols and procedures, and interact with peers. • Posts - Members can post thoughts, views, and links to articles and resources of interest to the CoP. • Chatbox chats - Members can engage in one-on-one chats with other members through private chatboxes. • Quizzes - The CoP will host quizzes through which members are able to test their knowledge acquisition levels after having accessed the learning resources provided on the platform. • Library of Resources - The Library of Resources will be an extensive catalogue of resources, information, tools, and research results that members can access through the CoP. • Podcasts - The CoP will host podcasts members can listen to in the course of expanding their knowledge in the practice area of work-related mental health. • Webinars - Webinars are online seminars that take the form of instructional sessions, presentations, discussions, or demonstrations. Webinars on the CoP will be online classes that can be viewed on demand by members, and may take any one of these forms. • Transcripts - Facilitators will furnish members of the CoP with transcripts of all A/V media - webinars and podcasts - to avail the community of an alternative method of accessing the information and insights provided. • Polls - From time to time, CoP facilitators will post polls asking the community for their views on what content is the most useful, what aspects of the platform are the most informative, and how the CoP could be improved. • Case Studies/Vignettes - Relevant case studies will be posted to the CoP so that GPs can access insights through practical explorations of the issues being dealt with and real-life treatment methods deployed in different situations. Participation in the CoP will be based on GP availability. We cannot therefore forecast GP engagement in the CoP nor have not established timeframe requirements/expectations around this. However, a very robust engagement policy has been developed to both track and follow up with GPs on their engagement in the Cop. Furthermore, we have a resource pool of 5 (potentially 6) Clinical Opinion Leaders who will have previously delivered the Academic Detailing training session to GPs. Clinical Opinion leaders are GPs who are well respected amongst their peers and considered experts in their field. These Opinion Leaders are also facilitators of the CoP and will be facilitators of the CoP. Given Opinion leaders will have already met many of the GPs from across NSW and Vic, we expect this to be an incentive for GPs to not only join the CoP but to continue to stay engaged in the CoP. Provision of Resources A range of resources will be provided to participants including but not limited to clinical resources, system resources, patient resources.