Cargando…
Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention
BACKGROUND: Primary care plays an important role in supporting survivors of cancer; however, support is limited because of practitioners’ perceived lack of expertise and time. A digital intervention for survivors of cancer could provide an efficient way for primary care staff to support survivors of...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015743/ https://www.ncbi.nlm.nih.gov/pubmed/35363143 http://dx.doi.org/10.2196/36364 |
_version_ | 1784688374936764416 |
---|---|
author | Smith, Jazzine Essery, Rosie Yardley, Lucy Richardson, Alison Slodkowska-Barabasz, Joanna Foster, Claire Watson, Eila Grimmett, Chloe Geraghty, Adam W A Little, Paul Bradbury, Katherine |
author_facet | Smith, Jazzine Essery, Rosie Yardley, Lucy Richardson, Alison Slodkowska-Barabasz, Joanna Foster, Claire Watson, Eila Grimmett, Chloe Geraghty, Adam W A Little, Paul Bradbury, Katherine |
author_sort | Smith, Jazzine |
collection | PubMed |
description | BACKGROUND: Primary care plays an important role in supporting survivors of cancer; however, support is limited because of practitioners’ perceived lack of expertise and time. A digital intervention for survivors of cancer could provide an efficient way for primary care staff to support survivors of cancer without the need to accumulate expertise and skills to help patients make behavior changes; providing very brief support alongside this could maximize adherence to digital interventions. Renewed is a digital intervention that combines web-based behavior change advice with brief health care practitioner support from a nurse or health care assistant. Knowledge about the views and experiences of primary care staff providing support alongside a digital intervention for survivors of cancer is sparse, limiting the understanding of the acceptability and feasibility of this type of intervention. OBJECTIVE: This study aims to explore supporters’ experiences of providing support to survivors of cancer using Renewed, understand potential barriers to and facilitators of the implementation of Renewed in practice, and investigate the strengths and weaknesses of the intervention from the perspective of health care professionals. METHODS: This was a qualitative process evaluation nested within a large trial evaluating Renewed. A total of 28 semistructured telephone interviews were conducted with nurses and health care assistants. Data were analyzed using inductive thematic analysis. RESULTS: Four themes were developed during the analysis, which reflected the factors that supporters identified as hindering or enabling them to provide support alongside Renewed Online: Renewed Online as an acceptable digital tool with some improvements, confidence in enacting the supporter role, practicalities of delivering support alongside a digital intervention, and managing a patient-led approach. The analysis suggests that supporters perceived that a digital intervention such as Renewed would be beneficial in supporting survivors of cancer in primary care and fit within current practices. However, barriers to providing support alongside the intervention were also identified, including concerns about how to facilitate rapport building and, in a minority, concerns about using a nondirective approach, in which most advice and support is provided through digital interventions, with brief additional support provided by primary care staff. CONCLUSIONS: These findings add to the literature on how best to provide support alongside digital interventions, suggesting that although most practitioners cope well with a nondirective approach, a minority requires more training to feel confident in implementing this. This study suggests that the barriers to providing formal support to survivors of cancer in primary care could be successfully overcome with an approach such as Renewed, where a digital intervention provides most of the support and expertise, and health care practitioners provide additional brief human support to maximize engagement. Strategies to maximize the chances of successful implementation for this type of intervention are also discussed. |
format | Online Article Text |
id | pubmed-9015743 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-90157432022-04-19 Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention Smith, Jazzine Essery, Rosie Yardley, Lucy Richardson, Alison Slodkowska-Barabasz, Joanna Foster, Claire Watson, Eila Grimmett, Chloe Geraghty, Adam W A Little, Paul Bradbury, Katherine JMIR Cancer Original Paper BACKGROUND: Primary care plays an important role in supporting survivors of cancer; however, support is limited because of practitioners’ perceived lack of expertise and time. A digital intervention for survivors of cancer could provide an efficient way for primary care staff to support survivors of cancer without the need to accumulate expertise and skills to help patients make behavior changes; providing very brief support alongside this could maximize adherence to digital interventions. Renewed is a digital intervention that combines web-based behavior change advice with brief health care practitioner support from a nurse or health care assistant. Knowledge about the views and experiences of primary care staff providing support alongside a digital intervention for survivors of cancer is sparse, limiting the understanding of the acceptability and feasibility of this type of intervention. OBJECTIVE: This study aims to explore supporters’ experiences of providing support to survivors of cancer using Renewed, understand potential barriers to and facilitators of the implementation of Renewed in practice, and investigate the strengths and weaknesses of the intervention from the perspective of health care professionals. METHODS: This was a qualitative process evaluation nested within a large trial evaluating Renewed. A total of 28 semistructured telephone interviews were conducted with nurses and health care assistants. Data were analyzed using inductive thematic analysis. RESULTS: Four themes were developed during the analysis, which reflected the factors that supporters identified as hindering or enabling them to provide support alongside Renewed Online: Renewed Online as an acceptable digital tool with some improvements, confidence in enacting the supporter role, practicalities of delivering support alongside a digital intervention, and managing a patient-led approach. The analysis suggests that supporters perceived that a digital intervention such as Renewed would be beneficial in supporting survivors of cancer in primary care and fit within current practices. However, barriers to providing support alongside the intervention were also identified, including concerns about how to facilitate rapport building and, in a minority, concerns about using a nondirective approach, in which most advice and support is provided through digital interventions, with brief additional support provided by primary care staff. CONCLUSIONS: These findings add to the literature on how best to provide support alongside digital interventions, suggesting that although most practitioners cope well with a nondirective approach, a minority requires more training to feel confident in implementing this. This study suggests that the barriers to providing formal support to survivors of cancer in primary care could be successfully overcome with an approach such as Renewed, where a digital intervention provides most of the support and expertise, and health care practitioners provide additional brief human support to maximize engagement. Strategies to maximize the chances of successful implementation for this type of intervention are also discussed. JMIR Publications 2022-04-01 /pmc/articles/PMC9015743/ /pubmed/35363143 http://dx.doi.org/10.2196/36364 Text en ©Jazzine Smith, Rosie Essery, Lucy Yardley, Alison Richardson, Joanna Slodkowska-Barabasz, Claire Foster, Eila Watson, Chloe Grimmett, Adam W A Geraghty, Paul Little, Katherine Bradbury. Originally published in JMIR Cancer (https://cancer.jmir.org), 01.04.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Smith, Jazzine Essery, Rosie Yardley, Lucy Richardson, Alison Slodkowska-Barabasz, Joanna Foster, Claire Watson, Eila Grimmett, Chloe Geraghty, Adam W A Little, Paul Bradbury, Katherine Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title | Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title_full | Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title_fullStr | Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title_full_unstemmed | Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title_short | Implementing a Health Care Professional–Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention |
title_sort | implementing a health care professional–supported digital intervention for survivors of cancer in primary care: qualitative process evaluation of the renewed intervention |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015743/ https://www.ncbi.nlm.nih.gov/pubmed/35363143 http://dx.doi.org/10.2196/36364 |
work_keys_str_mv | AT smithjazzine implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT esseryrosie implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT yardleylucy implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT richardsonalison implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT slodkowskabarabaszjoanna implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT fosterclaire implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT watsoneila implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT grimmettchloe implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT geraghtyadamwa implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT littlepaul implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention AT bradburykatherine implementingahealthcareprofessionalsupporteddigitalinterventionforsurvivorsofcancerinprimarycarequalitativeprocessevaluationoftherenewedintervention |