Abstract
BackgroundPersonal and community networks are recognized as influencing and shaping self‐management activities and practices. An acceptable intervention which facilitates self‐management by mobilizing network support and improves network engagement has a positive impact on health and quality of life. This study aims to identify the processes through which such changes and engagement take place.MethodsThe study was conducted in the south of England in 2016‐2017 and adopted a longitudinal case study of networks design. Purposive sample of respondents with long‐term conditions (n = 15) was recruited from local groups. Barriers and facilitators to implementation were explored in interviews with key stakeholders (5).ResultsIntervention engagement leads to a deepening of relationships within networks, adding new links and achieving personal objectives relevant for improving the health and well‐being of users and network members. Such changes are supported through two pathways: the mobilization of network capabilities and by acting as a nudge. The first is a gradual process where potentially relevant changes are further contemplated by forefronting immediate concerns and negotiating acceptable means for achieving change, prioritizing objective over subjective valuations of support provided by network members and rehearsing justifications for keeping the status quo or adopting change. The second pathway changes are enacted through the availability of a potential fit between individual, network and environmental conditions of readiness.ConclusionsThe two pathways of network mobilization identified in this study illuminate the individual, network and environmental level processes involved in moving from cognitive engagement with the intervention to adopting changes in existing practice.
Highlights
Personal and community networks are recognized as influencing and shaping self-management activities and practices
Social network interventions designed to mobilize resources have to compete alongside pre-existing practices and manage interactions between people and their contexts to ensure the acceptability, workability and integration of new ways of doing things in everyday life.[3,4]
Identifying rationales for making changes through engaging with options that might lead to change resonates with behaviour change and self-management theory which highlight the need for building a relationship of trust through rapport, establishing in people’s minds a need to be engaged in new practices and finding workable solutions that are most likely to be adopted by individual patients
Summary
Personal and community networks are recognized as influencing and shaping self-management activities and practices. Results: Intervention engagement leads to a deepening of relationships within networks, adding new links and achieving personal objectives relevant for improving the health and well-being of users and network members Such changes are supported through two pathways: the mobilization of network capabilities and by acting as a nudge. There is a recognition that providing person-centred care and understanding what people with long-term conditions value in relation to self-management requires exploring the contexts and ways in which social ties and resources shape everyday interactions and mechanisms through which changes in existing practice are negotiated.[1,2]. Self-directed support for managing health can be accessed through people’s social networks and engagement and is predicated on the wide range of connections available to people in open settings (family, friends, groups, acquaintances and pets) The latter provide opportunities for connectivity reciprocity and accessing resources amongst network members for support.[5]. In terms of living and managing well with a long-term condition (LTC) this means realizing and sustaining valued activities and participating in social, cultural and group activities 6,7 and maintaining and developing valued reciprocal relationships with others within proximate communities.[8,9]
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