INTRODUCTION : An internet-based cognitive behavioral therapy (ICBT) offers a way to
increase access to evidence-based tinnitus care. To increase the accessibility of this
intervention, the materials were translated into Spanish to reach Spanish as well as
English speakers. A clinical trial indicated favorable outcomes of ICBT for tinnitus for
the population of the United States. In view of later dissemination, a way to increase
the applicability of this intervention is required. Such understanding is best obtained
by considering the perspectives and experiences of participants of an intervention.
This study aimed to identify the processes that could facilitate or hinder the clinical
implementation of ICBT in the United States.
METHODS : This study evaluated the processes regarding enrolment, allocation,
intervention delivery, the outcomes obtained, and the trial implementation. The study
sample consisted of 158 participants who were randomly assigned to the experimental
and control group.
RESULTS : Although the recruitment was sufficient for English speakers, recruiting
the Spanish participants and participants belonging to ethnic minority groups
was difficult despite using a wide range of recruitment strategies. The allocation
processes were effective in successfully randomizing the groups. The intervention
was delivered as planned, but not all the participants chose to engage with
the materials provided. Compliance for completing the outcome measures
was low. The personal and intervention factors were identified as barriers for
the implementation whereas the facilitators included the support received,
being empowering, the accessibility of the intervention, and its structure.
CONCLUSION : An understanding regarding the factors contributing to the outcomes
obtained, the barriers and facilitators of the results, engagement, and compliance were
obtained. These insights will be helpful in preparing for the future dissemination of