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Providing online weight management in Primary Care: a mixed methods process evaluation of healthcare practitioners' experiences of using and supporting patients using POWeR.

Publication ,  Journal Article
Smith, E; Bradbury, K; Scott, L; Steele, M; Little, P; Yardley, L
Published in: Implement Sci
May 25, 2017

BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+. The usage analysis captured how 54 practitioners used the POWeR+ intervention. Thirteen telephone interviews explored practitioners' experiences of using POWeR+ and providing patients with face-to-face or remote (email and telephone) support. Interview data were analysed using inductive thematic analysis. RESULTS: Usage analysis indicated that almost all practitioners engaged with POWeR+. Pages which displayed patients' progress and allowed practitioners to email patients were used the most. Practitioners found POWeR+ straightforward and easy to use. Some practitioners preferred providing support face-to-face, which they enjoyed more than remote support. A small number of nurses found providing non-directive support using the CARe approach (Congratulate, Ask, Remind) challenging, feeling it was the opposite of their normal approach. POWeR+ enabled practitioners to raise the topic of weight loss with patients, and POWeR+ was viewed as a superior alternative to existing weight management support which was limited in most practices. Still some practitioners found it difficult to fit providing support into their busy schedules. CONCLUSIONS: Overall, practitioners engaged well with POWeR+ and perceived providing patients with support whilst using POWeR+ as acceptable and feasible. CARe provides a potentially useful model for how practitioners can combine human and digital support in a cost-effective way, which could be useful for the management of other conditions. Some potential barriers to implementation were identified, which allowed modification of POWeR+. The findings suggest that implementing this cost-effective online weight management intervention in Primary Care would be feasible and acceptable to practitioners. TRIAL REGISTRATION: ClinicalTrial.gov, ISRCTN21244703.

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Published In

Implement Sci

DOI

EISSN

1748-5908

Publication Date

May 25, 2017

Volume

12

Issue

1

Start / End Page

69

Location

England

Related Subject Headings

  • Telephone
  • Telemedicine
  • Primary Health Care
  • Middle Aged
  • Internet
  • Humans
  • Health Policy & Services
  • Health Personnel
  • Female
  • Body Weight Maintenance
 

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Smith, E., Bradbury, K., Scott, L., Steele, M., Little, P., & Yardley, L. (2017). Providing online weight management in Primary Care: a mixed methods process evaluation of healthcare practitioners' experiences of using and supporting patients using POWeR. Implement Sci, 12(1), 69. https://doi.org/10.1186/s13012-017-0596-6
Smith, Emily, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, and Lucy Yardley. “Providing online weight management in Primary Care: a mixed methods process evaluation of healthcare practitioners' experiences of using and supporting patients using POWeR.Implement Sci 12, no. 1 (May 25, 2017): 69. https://doi.org/10.1186/s13012-017-0596-6.
Journal cover image

Published In

Implement Sci

DOI

EISSN

1748-5908

Publication Date

May 25, 2017

Volume

12

Issue

1

Start / End Page

69

Location

England

Related Subject Headings

  • Telephone
  • Telemedicine
  • Primary Health Care
  • Middle Aged
  • Internet
  • Humans
  • Health Policy & Services
  • Health Personnel
  • Female
  • Body Weight Maintenance