Table 3 Challenges and barriers to program participation, and suggested future improvements, identified by staff and patient participants

Challenges for staff:

• Organisational aspects of a multiple-staff intervention (e.g. having enough staff to: facilitate different lecture topics, run computer training, or step in if someone is unavailable)

• Time commitment to help facilitate the intervention, and to complete paperwork

• Managing interpersonal difficulties amongst the patient group

Barriers to patients participating in program:

• Access to transport

• Wait time for groups to start

• Out of catchment area referrals

Suggested improvements:

• Having a dedicated person on team who manages program administration duties

• Providing psychoeducation (verbal or written) about the group-based format to patients prior to commencing the program, to ease any anxiety

• Organising transport options for patients to attend the program

• Embedding the program as a permanent part of the service, so that the timing of groups is predictable

• Expanding program participation to involve carers

• Ensuring ongoing links to other social groups in the community to ‘fill the gap’ once the program ends

• Modifying the program content for other populations (vision or hearing impaired, languages other than English)