Abstract
BackgroundFor 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.MethodsA 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.ResultsMost 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.ConclusionsThe 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0384-8) contains supplementary material, which is available to authorized users.
Highlights
For people with long-term conditions, social networks provide a potentially central means of mobilising, mediating and accessing support for health and well-being
Evidence of the positive role social networks have in managing a long-term condition suggests that current selfmanagement initiatives emphasising individual motivation and behaviour change are likely to be enhanced by the development and implementation of strategies for linking people to wider resources through engaging social networks and local support [3,4,5]
We focus on evaluating the acceptability, appropriateness and implementation of a collectively orientated long-term condition self-management strategy
Summary
For people with long-term conditions, social networks provide a potentially central means of mobilising, mediating and accessing support for health and well-being. We focus on evaluating the acceptability, appropriateness and implementation of a collectively orientated long-term condition self-management strategy. The approach and web-based tool have been designed to improve people’s ability to navigate and negotiate support available from within personal social networks and extend this to engagement with local groups and organisations [6]. This builds on an existing body of knowledge concerning implementation of self-management interventions. The tool has been developed to orientate delivery in community and domestic settings where people with long-term conditions are elicited as partners in making health and well-being choices with support from a semi-professionalised workforce
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