Using Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary care

dc.cclicenceCC-BY-NCen
dc.contributor.authorTurner, Jessica
dc.contributor.authorMartin, Graham
dc.contributor.authorHudson, Nicky
dc.contributor.authorShaw, Liz
dc.contributor.authorHuddlestone, Lisa
dc.contributor.authorWeis, Christina
dc.contributor.authorNorthern, Alison
dc.contributor.authorSchreder, Sally
dc.contributor.authorDavies, Melanie
dc.contributor.authorEborall, Helen
dc.date.acceptance2022-09-27
dc.date.accessioned2023-01-04T10:43:32Z
dc.date.available2023-01-04T10:43:32Z
dc.date.issued2022-09-27
dc.descriptionopen access articleen
dc.description.abstractBackground Referral and uptake rates of structured self-management education (SSME) for Type 2 diabetes (T2DM) in the UK are variable and relatively low. Research has documented contributing factors at patient, practitioner and organisational levels. We report a project to develop an intervention to improve referral to and uptake of SSME, involving an integrative synthesis of existing datasets and stakeholder consultation and using Normalisation Process Theory (NPT) as a flexible framework to inform the development process. Methods A three-phase mixed-methods development process involved: (1) synthesis of existing evidence; (2) stakeholder consultation; and (3) intervention design. The first phase included a secondary analysis of data from existing studies of T2DM SSME programmes and a systematic review of the literature on application of NPT in primary care. Influences on referral and uptake of diabetes SSME were identified, along with insights into implementation processes, using NPT constructs to inform analysis. This gave rise to desirable attributes for an intervention to improve uptake of SSME. The second phase involved engaging with stakeholders to prioritise and then rank these attributes, and develop a list of associated resources needed for delivery. The third phase addressed intervention design. It involved translating the ranked attributes into essential components of a complex intervention, and then further refinement of components and associated resources. Results In phase 1, synthesised analysis of 64 transcripts and 23 articles generated a longlist of 46 attributes of an embedded SSME, mapped into four overarching domains: valued, integrated, permeable and effectively delivered. Stakeholder engagement in phase 2 progressed this to a priority ranked list of 11. In phase 3, four essential components attending to the prioritised attributes and forming the basis of the intervention were identified: 1) a clear marketing strategy for SSME; 2) a user friendly and effective referral pathway; 3) new/amended professional roles; and 4) a toolkit of resources. Conclusions NPT provides a flexible framework for synthesising evidence for the purpose of developing a complex intervention designed to increase and reduce variation in uptake to SSME programmes in primary care settings.en
dc.funderOther external funder (please detail below)en
dc.funder.otherNational Institute for Health Research (NIHR)en
dc.identifier.citationTurner, J., Martin, G., Hudson, N. et al. (2022) Using Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary care. BMC Health Service Research, 22, 1206en
dc.identifier.doihttps://doi.org/10.1186/s12913-022-08553-7
dc.identifier.urihttps://hdl.handle.net/2086/22400
dc.language.isoenen
dc.peerreviewedYesen
dc.publisherBMC Health Services Researchen
dc.researchinstituteCentre for Reproduction Research (CRR)en
dc.subjectType 2 diabetesen
dc.subjectSelf-management Structured Educationen
dc.subjectIntervention developmenten
dc.subjectQualitativeen
dc.subjectNormalisation Process Theoryen
dc.titleUsing Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary careen
dc.typeArticleen

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