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Background: Supported self‐management (SSM) for asthma reduces the risk of asthma attacks and improves asthma control and quality of life. SSM optimally includes patient‐centred communication and behaviour change support, however, the extent to which this occurs in routine primary care is unclear. This project was nested within the IMPlementing IMProved Asthma self‐management as RouTine (IMP2ART) programme; a UK‐wide trial evaluating an implementation strategy (including healthcare professional (HCP) training on behaviour change strategies and patient‐centred care) to improve support for asthma self‐management. Objective: To provide an understanding of how healthcare professionals deliver SSM in UK clinical practice; through assessing time spent on SSM strategies, how and to what extent patient‐centred care and behaviour change discussions are delivered, and to explore whether factors such as mode of review or implementation support influence delivery. Design, Setting and Participants: We conducted an observational study using video‐recordings of 12 HCPs delivering routine face‐to‐face and telephone asthma reviews (n = 64) in a sample of general practices participating in the IMP2ART trial (implementation n = 4; control n = 6). Analytical methods included: ALFA Toolkit Multi‐Channel Video Observation (to code and quantify tasks undertaken); the Patient‐Centred Observation Form; and The Behaviour Change Counselling Index (to assess patient‐centeredness and behaviour change counselling used by HCPs). Results: HCPs mostly spent time during routine asthma reviews discussing: an individual's asthma condition and management (average of 27.8% of consultation time); collaboratively reviewing and completing a personalised asthma action plan (6.3%) and training for practical self‐management activities (5.4%). Areas of patient‐centred care delivery and behavioural discussions included: creating and maintaining relationships, discussing asthma action plans and medication reconciliation. Professionals in IMP2ART implementation group practices delivered more SSM strategies. Comparison of face‐to‐face and remote consultations found no significant differences in HCP delivery of SSM. Conclusions: HCPs in UK primary care spent half the time in both face‐to‐face and remote asthma reviews delivering components of SSM suggesting that either mode of delivery may be acceptable. Reviews carried out in IMP2ART implementation group practices demonstrated more behaviour change and collaborative SSM strategies compared to those in the control group. Patient and Public Contribution: Asthma UK Centre for Applied Research (AUKCAR) PPI members were involved throughout, including project conception, providing feedback on participant‐facing documents, and discussing implications of study findings. [ABSTRACT FROM AUTHOR]

Background: We investigated whether a novel 8‐week personalised health behaviour support programme, focusing on the stability of symptoms and strategies to improve activities of daily living, was feasible and acceptable in adults with post‐COVID syndrome. Methods: In this randomised, controlled, pilot feasibility trial, 32 adults with post‐COVID syndrome (continued symptoms for ≥ 12 weeks) were randomised 1:1 to receive personalised health behaviour support (self‐reported physical activity and symptom diaries, plus seven one‐to‐one remotely delivered personalised self‐management support sessions), once weekly for 8‐weeks, or usual care (referral to online 'your COVID‐19 recovery' programme). The primary outcome was the feasibility of recruiting and randomising adults with post‐COVID syndrome. The secondary outcomes were to assess the acceptability and safety of the intervention and various outcome measures. Results: Of the 48 adults who expressed interest in the study, 32 (67%) were eligible and completed the baseline assessment. All 32 adults were willing to be randomised to either the personalised health behaviour support programme (n = 17) or usual care (n = 15) and 27 (age: 45 ± 12 years) adults completed follow‐up at 9 weeks. The intervention was deemed feasible, with high adherence (92% and 94% completion rates for the physical activity and symptom diaries, respectively) and excellent acceptability rates (94% 'liked the intervention a lot'). The intervention was deemed safe, with no symptom exacerbations reported. Conclusion: An 8‐week personalised health behaviour support programme was feasible for adults with post‐COVID syndrome, with good adherence and acceptability rates. Early pilot data from this small sample also suggests meaningful improvements in physical activity, fatigue and respiratory symptoms. Patient or Public Contribution: People living with post‐COVID syndrome were involved from the outset with the study design, review of study documentation and interpretation of the data following completion. Furthermore, several participants have supported the local dissemination of findings following the completion of the study. [ABSTRACT FROM AUTHOR]

People living with stroke and neurological conditions access rehabilitation at different times but self-management is often viewed as what happens post-discharge. Personalised models that integrate self-management support within everyday care are now advocated but this may require practitioners to change their behaviour to adopt and sustain new ways of working. The People1st project evaluated integration of an existing Supported Self-Management programme ("Bridges") across varied stroke and neurorehabilitation service contexts. Mixed-method evaluation of training for groups of healthcare practitioners across 24 UK National Health Service (NHS) Trusts, exploring how learning from Bridges was assimilated and enacted in practice, on an individual and collective basis. Staff growth in confidence and skill around supported self-management was demonstrated. Transformations to practice included changes to: the structure of, and language used in, patient interactions; induction/training processes to increase potential for sustainability; and sharing of successes. Bridges helped practitioners make changes that brought them closer to their professional ideals. Engaged leadership was considered important for successful integration. Bridges was successfully integrated within a wide range of stroke and neurorehabilitation service contexts, enabled by an approach in line with practitioners' values-based motivations. Further work is required to explore sustainability and impact on service users. Personalised models of care and support for self-management are advocated for people living with stroke and neurological conditions; this requires practitioners to be supported to change behaviour and practices to adopt and sustain new ways of working. Staff from a wide variety of backgrounds in neurorehabilitation and stroke can learn collaboratively about self-management practices via the Bridges programme and can integrate those practices into their service contexts. Bridges can take practitioners closer to their professional ideals of caring and making a difference and empowers them to initiate change. Organisational commitment and engaged leadership are required to facilitate a culture of support for self-management in practice. [ABSTRACT FROM AUTHOR]

Background: Adjusting to life with a chronic condition is challenging, especially for people with limited health literacy, which is associated with low compliance with self‐management activities and poor clinical outcomes. Objective: We explored how people with limited health literacy understand asthma and undertake self‐management practices. Design: We adapted the arts‐based qualitative methodology Photovoice. Setting and Participants: We sampled ethnically diverse adults with asthma and limited health literacy from four primary healthcare clinics in Malaysia. After a semistructured in‐depth interview, a subset of participants took part in the Photovoice component in which participants undertook a 2‐week photo‐taking activity and subsequent photo‐interview. Interviews, conducted in participants' preferred language, were audio‐recorded, transcribed verbatim, translated and analysed thematically. We used the Sorensen's framework (Domains: access, understand, appraise, apply) to describe participants' experience of living with asthma, what they understood about asthma and how they decided on self‐management practices. Results: Twenty‐six participants provided interviews; eight completed the Photovoice activities. Participants with limited health literacy used various sources to access information about asthma and self‐management. Doctor–patient communication had a pivotal role in helping patients understand asthma. The lack of appraisal skills was significant and experiential knowledge influenced how they applied information. Self‐management decisions were influenced by sociocultural norms/practices, stigmatizing experiences, and available social support. Conclusion: Locally tailored multilevel interventions (interpersonal, health system, community and policy) will be needed to support people with limited health literacy to live optimally with their asthma in an ethnically diverse population. Patient/Public Contribution: Patients were involved in the study design, recruitment, analysis and dissemination. [ABSTRACT FROM AUTHOR]

Since the mid-1980s, female breast cancer deaths have fallen by 40% in the UK, largely due to increasingly successful treatments. The growing number of cancer survivors has resulted in a move away from traditional follow-up methods, towards supported self-management programmes. This article describes a service evaluation project in which patients who attended an end-of-treatment interview were asked about their experience of a newly implemented supported self-management programme. Analysis of the data reveals that patients understand the new pathway, and are confident in the system and their own ability to reaccess clinicians when required. It also shows that breast care nurses can help reduce hospital appointments. [ABSTRACT FROM AUTHOR]

Cancer incidence is increasing year on year; survivorship rates are also increasing, as is the use of novel agents and additional treatment lines. These factors, along with evidence that suggests people are struggling to cope with the long-term effects of their diagnosis and its treatment, suggest we need to transform our approach to care and make better use of primary care, community assets and self-management. Transforming Care After Treatment (TCAT) was launched in 2013. A partnership between the Scottish Government, Macmillan Cancer Support, NHS Scotland and local authorities, it is intended to support and enable cancer survivors to live as healthy a life as possible for as long as possible. NHS Ayrshire and Arran worked with local patients and other partners to develop an action plan to meet TCAT's aims. In 2014, the TCAT team began to introduce initiatives that would support holistic care throughout the extended cancer pathway. One such initiative was a treatment summary. The approach to its implementation and patients' and GPs' perspectives of its initial effect are outlined in this paper. [ABSTRACT FROM AUTHOR]