scholarly journals Process evaluation of the Restore4stroke Self-Management intervention ‘Plan Ahead!’: a stroke-specific self-management intervention

2016 ◽  
Vol 30 (12) ◽  
pp. 1175-1185 ◽  
Author(s):  
Nienke S Tielemans ◽  
Vera PM Schepers ◽  
Johanna MA Visser-Meily ◽  
Jolanda CM van Haastregt ◽  
Wendy JM van Veen ◽  
...  
Keyword(s):  
Peer Support ◽  
Mixed Method ◽  
Qualitative Data ◽  
Action Planning ◽  
Self Management ◽  
Planning Tool ◽  
Stroke Patients ◽  
Management Intervention ◽  
Management Interventions ◽  
Intervention Plan

Objective: To investigate whether the self-management intervention was implemented as intended. Additionally, we studied involvement in and satisfaction with the intervention among patients, their partners and therapists. Design: Mixed method, prospective study. Setting: Outpatient facilities of hospitals/rehabilitation centres. Participants: Stroke patients, their partners and therapists from the experimental arm of the Restore4Stroke Self-Management study. Intervention: ‘Plan Ahead!’ is a 10-week self-management intervention for stroke patients and partners, consisting of seven two-hour group sessions. Proactive action planning, education and peer support are main elements of this intervention. Main measures: Session logs, questionnaires for therapists, patients and their partners, and focus groups. Data analysis: Qualitative data were analysed with thematic analysis supplemented by quasi-statistics. Quantitative data were reported as descriptive statistics. Results: The study sample consisted of 53 patients and 26 partners taking part in the intervention, and all therapists delivering the intervention ( N = 19). At least three-quarters of the intervention sessions were attended by 33 patients and 24 partners. On a scale from 1 to 10, patients, partners and therapists rated the intervention with mean scores of 7.5 (SD1.6), 7.8 (SD.7) and 7.4 (SD.7), respectively. Peer support was the most frequently appreciated element for participants and therapists. The proactive action planning tool was adequately applied in 76 of the 96 sessions. Conclusion: Although the target audience was reached and both participants and therapists were satisfied with the intervention, the proactive action planning tool that distinguishes the current intervention from existing stroke-specific self-management interventions was only partly implemented according to protocol.

scholarly journals The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Megan Hofmann ◽  
Charlotte Dack ◽  
Chris Barker ◽  
Elizabeth Murray
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Method ◽  
Self Efficacy ◽  
Qualitative Data ◽  
Well Being ◽  
Self Management ◽  
Psychological Well Being ◽  
Management Intervention ◽  
The Impact

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants’ diabetes-related distress (Z=2.04,p=0.04, andd=0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.

scholarly journals Development and evaluation of an eHealth self-management intervention for patients with chronic kidney disease in China: protocol for a mixed-method hybrid type 2 trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongxia Shen ◽  
Rianne van der Kleij ◽  
Paul J. M. van der Boog ◽  
Xiaoyue Song ◽  
Wenjiao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Self Management ◽  
Evidence Based ◽  
Management Intervention ◽  
Management Interventions ◽  
Improve Health Status ◽  
Improve Health

Abstract Background Chronic kidney disease (CKD) is a significant public health concern. In patients with CKD, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve health-related outcomes of patients with CKD. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of patients with CKD and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2–5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design will be employed to investigate the effectiveness of the intervention using a cluster randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China, which has the potential to optimize patients’ self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts. Trial registration Clinicaltrials.gov NCT04212923; Registered December 30, 2019.

scholarly journals The Restore4Stroke self-management intervention ‘Plan ahead!’: rationale and description of the treatment protocol based on proactive action planning

2014 ◽  
Vol 28 (6) ◽  
pp. 530-540 ◽  
Author(s):  
Nienke S Tielemans ◽  
Vera PM Schepers ◽  
Johanna MA Visser-Meily ◽  
Jos van Erp ◽  
Mariette Eijkenaar ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Action Planning ◽  
Self Management ◽  
Management Intervention ◽  
Intervention Plan

Development and evaluation of an eHealth self-management intervention for chronic kidney disease patients in China: protocol for a mixed-method hybrid type 2 trial

2020 ◽  
Author(s):  
Hongxia Shen ◽  
Rianne van der Kleij ◽  
Paul JM van der Boog ◽  
Xiaoyue Song ◽  
Wenjiao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Self Management ◽  
Evidence Based ◽  
Management Intervention ◽  
Management Interventions ◽  
Improve Health Status ◽  
Improve Health

Abstract Background Chronic kidney disease (CKD) is a significant public health concern. In CKD patients, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve CKD patients’ health-related outcomes. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of CKD patients and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2-5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design (N=60) will be employed to investigate the effectiveness of the intervention using a pilot randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for CKD patients in China, which has the potential to optimize patients' self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts.

scholarly journals Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015452 ◽  
Author(s):  
Elaine Toomey ◽  
James Matthews ◽  
Deirdre A Hurley
Keyword(s):  
Low Back Pain ◽  
Mixed Methods ◽  
Qualitative Data ◽  
Self Report ◽  
Self Management ◽  
Low Back ◽  
Complex Behaviour ◽  
Management Intervention ◽  
Direct Observations ◽  
Audio Recordings

Objectives and designDespite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design.SettingFeasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy.Methods and outcomes60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation.ResultsQuantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists’ individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists’ knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity.ConclusionThe intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors.Trial registration numberISRCTN49875385; Pre-results.

scholarly journals Developing an Indigenous goal-setting tool: Counting Coup

2020 ◽  
Vol 1 (1) ◽  
pp. 49-57
Author(s):  
Iitáa Dáakuash ◽  
Alma McCormick ◽  
Shannen Keene ◽  
John Hallett ◽  
Suzanne Held
Keyword(s):  
Chronic Illness ◽  
Goal Setting ◽  
Indigenous Communities ◽  
Self Management ◽  
Future Research ◽  
Goal Theory ◽  
Management Intervention ◽  
Management Interventions ◽  
Indigenous Paradigm ◽  
Relational Accountability

Chronic illness self-management best practices include goal-setting as an important tool for developing better self-management habits and are often included as elements of chronic disease self-management interventions. However, the goal theory that many of these tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the [blinded] program, a chronic illness management intervention, we developed a goal-setting tool specific to the [blinded] Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the [blinded] culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of their communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup’s foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards behavior change.

scholarly journals Individually tailored self-management app-based intervention (selfBACK) versus a self-management web-based intervention (e-Help) or usual care in people with low back and neck pain referred to secondary care: protocol for a multiarm randomised clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047921
Author(s):  
Anna Marcuzzi ◽  
Kerstin Bach ◽  
Anne Lovise Nordstoga ◽  
Gro Falkener Bertheussen ◽  
Ilya Ashikhmin ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Usual Care ◽  
Secondary Care ◽  
Self Management ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Web Based ◽  
Management Intervention ◽  
Management Interventions

IntroductionLow back pain (LBP) and neck pain (NP) are common and costly conditions. Self-management is a key element in the care of persistent LBP and NP. Artificial intelligence can be used to support and tailor self-management interventions, but their effectiveness needs to be ascertained. The aims of this trial are (1) to evaluate the effectiveness of an individually tailored app-based self-management intervention (selfBACK) adjunct to usual care in people with LBP and/or NP in secondary care compared with usual care only, and (2) to compare the effectiveness of selfBACK with a web-based self-management intervention without individual tailoring (e-Help).Methods and analysisThis is a randomised, assessor-blind clinical trial with three parallel arms: (1) selfBACK app adjunct to usual care; (2) e-Help website adjunct to usual care and (3) usual care only. Patients referred to St Olavs Hospital, Trondheim (Norway) with LBP and/or NP and accepted for assessment/treatment at the multidisciplinary outpatient clinic for back or neck rehabilitation are invited to the study. Eligible and consenting participants are randomised to one of the three arms with equal allocation ratio. We aim to include 279 participants (93 in each arm). Outcome variables are assessed at baseline (before randomisation) and at 6-week, 3-month and 6-month follow-up. The primary outcome is musculoskeletal health measured by the Musculoskeletal Health Questionnaire at 3 months. A mixed-methods process evaluation will document patients’ and clinicians’ experiences with the interventions. A health economic evaluation will estimate the cost-effectiveness of both interventions’ adjunct to usual care.Ethics and disseminationThe trial is approved by the Regional Committee for Medical and Health Research Ethics in Central Norway (Ref. 2019/64084). The results of the trial will be published in peer-review journals and presentations at national and international conferences relevant to this topic.Trial registration numberNCT04463043.

scholarly journals Who Signs Up for and Engages in a Peer Support Heart Failure Self-management Intervention

2015 ◽  
Vol 30 ◽  
pp. S35-S43 ◽  
Author(s):  
Rebecca Mase ◽  
Lakshmi Halasyamani ◽  
Hwajung Choi ◽  
Michele Heisler
Keyword(s):  
Heart Failure ◽  
Peer Support ◽  
Self Management ◽  
Management Intervention
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