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Implementing a social network intervention designed to enhance and diversify support for people with long-term conditions. A qualitative study

Implementing a social network intervention designed to enhance and diversify support for people with long-term conditions. A qualitative study
Implementing a social network intervention designed to enhance and diversify support for people with long-term conditions. A qualitative study
BACKGROUND: For people with long-term conditions, social networks provide a potentially central means of mobilising, mediating and accessing support for health and well-being. Few interventions address the implementation of improving engagement with and through social networks. This paper describes the development and implementation of a web-based tool which comprises: network mapping, user-centred preference elicitation and need assessment and facilitated engagement with resources. The study aimed to determine whether the intervention was acceptable, implementable and acted to enhance support and to add to theory concerning social networks and engagement with resources and activities.

METHODS: A longitudinal design with 15 case studies used ethnographic methods comprising video, non-participant observation of intervention delivery and qualitative interviews (baseline, 6 and 12 months). Participants were people with type 2 diabetes living in a marginalised island community. Facilitators were local health trainers and care navigators. Analysis applied concepts concerning implementation of technology for self-management support to explain how new practices of work were operationalised and how the technology impacted on relationships fit with everyday life and allowed for visual feedback.

RESULTS: Most participants reported identifying and taking up new activities as a result of using the tool. Thematic analysis suggested that workability of the tool was predicated on disruption and reconstruction of networks, challenging/supportive facilitation and change and reflection over time concerning network support. Visualisation of the network enabled people to mobilise support and engage in new activities. The tool aligned synergistically with the facilitators' role of linking people to local resources.

CONCLUSIONS: The social network tool works through a process of initiating positive disruption of established self-management practice through mapping and reflection on personal network membership and support. This opens up possibilities for reconstructing self-management differently from current practice. Key facets of successful implementation were: the visual maps of networks and support options; facilitation characterised by a perceived lack of status difference which assisted engagement and constructive discussion of support and preferences for activities; and background work (a reliable database, tailored preferences, option reduction) for facilitator and user ease of use.
social networks, long-term conditions, self-management support, qualitative
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Vassilev, Ivaylo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
James, Elizabeth
b7e90b5a-da45-4459-ae84-150adc07e988
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Vassilev, Ivaylo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
James, Elizabeth
b7e90b5a-da45-4459-ae84-150adc07e988
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7

Kennedy, Anne, Vassilev, Ivaylo, James, Elizabeth and Rogers, Anne (2016) Implementing a social network intervention designed to enhance and diversify support for people with long-term conditions. A qualitative study. Implementation Science, 11, [27]. (doi:10.1186/s13012-016-0384-8).

Record type: Article

Abstract

BACKGROUND: For people with long-term conditions, social networks provide a potentially central means of mobilising, mediating and accessing support for health and well-being. Few interventions address the implementation of improving engagement with and through social networks. This paper describes the development and implementation of a web-based tool which comprises: network mapping, user-centred preference elicitation and need assessment and facilitated engagement with resources. The study aimed to determine whether the intervention was acceptable, implementable and acted to enhance support and to add to theory concerning social networks and engagement with resources and activities.

METHODS: A longitudinal design with 15 case studies used ethnographic methods comprising video, non-participant observation of intervention delivery and qualitative interviews (baseline, 6 and 12 months). Participants were people with type 2 diabetes living in a marginalised island community. Facilitators were local health trainers and care navigators. Analysis applied concepts concerning implementation of technology for self-management support to explain how new practices of work were operationalised and how the technology impacted on relationships fit with everyday life and allowed for visual feedback.

RESULTS: Most participants reported identifying and taking up new activities as a result of using the tool. Thematic analysis suggested that workability of the tool was predicated on disruption and reconstruction of networks, challenging/supportive facilitation and change and reflection over time concerning network support. Visualisation of the network enabled people to mobilise support and engage in new activities. The tool aligned synergistically with the facilitators' role of linking people to local resources.

CONCLUSIONS: The social network tool works through a process of initiating positive disruption of established self-management practice through mapping and reflection on personal network membership and support. This opens up possibilities for reconstructing self-management differently from current practice. Key facets of successful implementation were: the visual maps of networks and support options; facilitation characterised by a perceived lack of status difference which assisted engagement and constructive discussion of support and preferences for activities; and background work (a reliable database, tailored preferences, option reduction) for facilitator and user ease of use.

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More information

Accepted/In Press date: 16 February 2016
e-pub ahead of print date: 29 February 2016
Published date: 29 February 2016
Keywords: social networks, long-term conditions, self-management support, qualitative
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 389451
URI: http://eprints.soton.ac.uk/id/eprint/389451
PURE UUID: a858b901-13d4-418c-88d5-287aec4b68b6
ORCID for Anne Kennedy: ORCID iD orcid.org/0000-0003-4570-9104
ORCID for Elizabeth James: ORCID iD orcid.org/0000-0001-9355-0295

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Date deposited: 08 Mar 2016 11:33
Last modified: 23 Feb 2021 02:42

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