title: [Factors related to adoption of a family peer-education program on mental disorders. Dissemination research of the Omotenashi-Family Experiences Learning Program].
abstract: OBJECTIVE
  To identify effective dissemination strategies regarding a family peer-education program, the Omotenashi-Family Experiences Learning Program, on mental disorders, we evaluated factors related to the program adoption by family groups.
  
  
  METHODS
  A cross-sectional mail survey was conducted from June to September 2013, involving 12 family group associations for mental disorders and their affiliated local family groups. For the analysis, we used the conceptual framework of diffusion and dissemination of innovations in a health-care organization. We divided the adaptation process into two steps: (1) understanding the program information, involved the level of program information sharing (with or without family group members); and (2) adaptation decision, involved the adaptation plan (planned or under consideration, or no plan). Data were analyzed regarding the differences between the two categories of the dependent variable in each step, and a logistic regression was conducted in the first step.
  
  
  RESULTS
  Ten associations agreed to participate in the survey. Of the 177 family groups that had not adopted the program, 110 family groups responded to the survey (response rate 62.1%). In the first step, a municipal population where the family groups were located of over 10,000 (OR = 5.53, 95%CI; 1.93-15.89), influential individuals who strongly recommended the program (OR=5.22, 95%CI; 1.46-18.69), and information acquisition through the association (OR=3.41, 95% CI; 1.27-9.17) were related to the shared program information in the family group. In the second step, data from 39 family groups that shared the program information with family members were analyzed. The family groups with adaptation plans that were planned or under consideration had significantly more board members, labor, and motivated members compared to the family groups without adaptation plans. The former groups had significantly fewer concerns with the program's difficulties, risks, and tasks than the latter groups. The former groups expected significantly more memberships and more effective mutual member support, experienced greater correspondence between concerns of the family group or family group members and the program's content, and were not opposed to the program.
  
  
  CONCLUSIONS
  Greater family-group awareness of the program could occur through the involvement of influential figures and provision of program information through family group associations. Program implementation involving other family groups and for non-group member families could lead to increased program adoption.
authors.affiliation: Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo.
authors.forename: Masako
authors.initials: M
authors.lastname: Kageyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Yukako
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nishina
authors.forename: Iwao
authors.initials: I
authors.lastname: Oshima
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000628:therapy*