Long Term Effect on Professionals' Knowledge, Practice and Attitudes towards User Involvement Four Years after Implementing an Organisational Development Plan: A Controlled Study

Background Health service organisations are increasingly implementing user involvement initiatives according to requirements from governments, such as user representation in administrational boards, better information to users, and more involvement of the users during treatment. Professionals are vital in all initiatives to enhance user involvement, and initiatives to increase involvement should influence the professionals' practice and attitudes. The implementation of a development plan intending to enhance user involvement in a mental health hospital in Central Norway had no effect on the professionals after 16 months. The objective was therefore to investigate the long term effect on the professionals' knowledge, practice and attitudes towards user involvement after four years. Methods This was a non-randomized controlled study including professionals from three mental health hospitals in Central Norway. A development plan intended to enhance user participation was implemented in one of the hospitals, including establishing a patient education centre and a user office, purchasing of user expertise, appointing contact professionals for next of kin, and improving of the centre's information and the professional culture. The professionals at two other hospitals constituted the control group. All professionals were invited to answer the Consumer Participation Questionnaire (CPQ) and additional questions, at a four year interval. Results A total of 399 professionals participated (43% response rate). Comparing the changes in the intervention group with the changes in the control group, the results showed that the plan had improved some aspects of the professionals' knowledge about the user involvement taking place in the hospital. In addition, some parts of the professionals' practice of providing information to the service users was improved, and the development plan might have raised their awareness about insufficient involvement of next of kin. Conclusions This is the first controlled study on the long term effect on professionals from implementing a development plan to enhance user participation in a mental health hospital. Since there was more effect after four years than after 16 months, this study indicates that it takes time before the effect of complex interventions to enhance patient participation in organisations can be detected among the professionals. More long-term studies are thus warranted.